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GIFT or 

DR. FRED M. HAYES 




r 



TEXT BOOK 



OF 



VETERINARY MEDICINE 



BY 



JAMES LAW, F.R.C.V.S. 



Director of the New York SUte Veterinary College 
Cornell UnWersity, Ithaca, N. Y. 



VOL. Ill 



SECOND EDITION 

REVISED AND ENLARGED 



DISEASES OF THE NERVOUS SYSTEM— GENITO- 
URINARY ORGANS— EYE— SKIN : CONSTI- 
TUTIONAL DISEASES 

Mi.KARY 

UNIVfiRSIfV^ OP CALIFORNIA" 
DAVIS 

ITHACA 

PUBLI8HBD BY TRK AUTHOR 

1905 

]/ 



Copyright by 

JAMKS LAW 

1900 



PRRSS OF 

ANDRUS & CHURCH 

ITHACA, If. Y. 



VETERINARY MEDICINE. 



DISEASES OF THE NERVOUS SYSTEM. 

Nervous control of bodily functions : affected through disease of nerve 
centres or nerve trunks, sensory, motor, vaso-motor, etc. Modes of im- 
paired nervous function : objective ; subjective. Nervous characteristics 
in different breeds, individuals, sexes, castrated animals. Nervous disorder 
from microbian toxins, narcotics, nervous stimulants, etc. 

All bodily functions are more or less directly controlled by the 
nervous system, hence nervous troubles are interwoven with the 
diseases of all other organs. Disorder of the nerve centres or 
nerve trunks affects the most distant parts over which these pre- 
side, or to and from which they convey nervous impulse. In 
different cases we see this operating through the sensory or 
motor functions, through lack of coordination or of balance, 
through modification of the circulation, respiration, secretion, 
absorption, nutrition, metabolism, special sensation, intellection, 
emotion, etc. These manifestations are less evident or less diag- 
nostic in the lower animal, because we cannot fully avail of the 
subjective symptoms. While the human patient can tell us his 
feelings and experience in their regular order and succession, we 
can only infer most of these in the animal, through dependent 
objective symptoms. In many cases we cannot even infer for 
lack of dependent symptoms. 

The practitioner must carefully watch for and accurately ob- 
serve all objective symptoms, and seek to rightly interpret them. 
Among other things he must note the nervous conformation, or- 
ganization and susceptibility ; the hereditary nervous characteris- 
tics as seen in breeds, temperament, habit, aptitude to learn, 
docility, instinct, intelligence, emotions and affections, and judge 
the case in the light of these. Similarly he must take into ac- 
count the hereditary, racial and individual irritability, obstinacy, 
restiveness, vice, alertness, sluggishness, stupidity, moroseness, 
and diagnose accordingly. Congestion, anaemia, coma, paresis, 
paralysis, may result from the nervous disorder and offer valu- 



jj^^^"^ 



2 Veterinary Medicine, 

able concurrent testimony to the same. Allowance must always 
be made for the use to which the animal has been put, thvis sexu- 
ality tells strongly in the horse, bull, boar, or ram which has 
been used for breeding and has become relatively indocile and 
even dangerous ;yi7^^ tells in a horse that ** shows his com", 
and in the dog fed on flesh ; the comparatively untrained English 
race horse is far less docile than the one inured to saddle or har- 
ness and the horse fresh from the range, though previously 
trained, is far less tractable than the one in steady work. The 
sexual products are especially liable to modify the temper, hence 
the docility of the gelding, and castrated mare, and the undis- 
turbed life and steady growth and fattening of castrated animals 
from cattle to capons 

The products of certain diseases and many drugs derange the in- 
nervation and intellection. Of this we have examples in the 
hebetude of the victims of milk sickness and dourine, in the wild 
delirium of rabies, in the varied nervous disorders that attend on 
the use of narcotics, essential oils, alcohol, chloral, sulphonal, 
trional, strychnia, lead, phosphorus, arsenic, etc. 



GENERAL SYMPTOMATOLOGY AND DIAGNOSIS. 

Motor disorders : paralysis, paresis, hemiplegia, crossed hemiplegia, spinal 
hemiplegia, paraplegia, monoplegia, local palsy, pseudo-paralysis, spasm, — 
tonic, clonic, tremor, hemispasm, monospasm, spasm of eyeball, spasm of 
head, paraplegic spasm, general spasms — convulsions, local spasms. Inco- 
ordination. Staggering. Reflex action. Morbid reflex : increased reflex, 
reflex tonic spasm. 

It seems desirable to note specially some of the more prominent 
morbid nervous phenomena and conditions, with lesions or other 
conditions which cause them, before considering what are usually 
recognized as special diseases. 

MOTOR DISORDERS. 

Paralysis (Akinesis) is loss of voluntary or involuntary 
muscular movement through defective inervation. 

Paresis is a paralysis which is partial in degree ; power of 
motion is impaired but not completely lost. 



General Symtomatology and Diagnosis, 3 

Hemiplegia is the loss of voluntary motion in many muscles 
on one side of the face or body. In general hemiplegia, the fol- 
lowing muscles are usually excepted : — muscles of the tongue, of 
mastication, of the eye, of respiration, of the neck and trunk 
generally and of the proximal part of the limbs. The hind limbs 
are usually most afiFected, and muscles that are most exclusively 
under the control of the will — those dominated by the cortical 
centres of the brain. When due to a clot on the brain or de- 
generation it occurs on the side opposite to that occupied by the 
dot, on accotmt of the motor fibres crossing at the anterior pyra- 
mids of the medulla. Hemianaesthesia is a rare attendant and 
when present is often on the side opposite to the hemiplegia. 
Sensory fibres cross in the spinal cord, and the lesion is probably 
spinal. 

Crossed Hemiplegia is motor paralysis of certain cephalic 
nerves (3d, 7th, 5th, 6th, and 8th, ) on the 3ame side with the clot 
or lesion, and of the muscles of the trunk on the other side. The 
cranial nerves proceed to muscles on the same side as their 
origin, while filaments going to the trunk through the spinal 
cord, cross in the pyramids (motor), or spinal cord (sensory). 
In crossed hemiplegia, hemianaesthesia is common with both 
forms of paralysis on one side. 

Spinal Hemiplegia has the face and head sound (except 
sometimes the iris), and half the body paralyzed on the side on 
which the spinal lesion (clot) exists. If anaesthesia exists it is on 
the side opposite to the lesion and posterior to it — the sensory 
filaments crossing just before leaving the cord. 

Paraplegia is loss of voluntary power of one transverse half 
of the body ; usually the posterior, and affects the tail, and has 
coincident anaesthesia, being due to a spinal lesion. Anal and 
vesical sphincters may or may not be paralyzed according as the 
lesions implicate their respective spinal centres or not. If there 
is neither anaesthesia nor vesical paralysis the lesion may be cere- 
bral, in the paracentral lobes of both hemispheres (meso-vertix 
at the fissure of Rolando. ) 

Monoplegia is a circumscribed paralysis, as of one limb, or on 
one side of the face, one group of muscles or a single muscle. 
It may be due to cerebral, spinal or nervous lesion. Cerebral 
monoplegias are distinguished by : ist, initial spasm ; 2nd, ab- 



4 Veterinary Medicine, 

sence of anaesthesia ; 3d, persistence of nutrition ; 4th, paralysis 
greatest in the distal portion of the member. 

Localized Paralysis is usually due to the lesion of a nerve, and 
is both motor and sensory. If due to a spinal lesion it usually 
affects one or more groups of muscles. In case the lesion is in 
the nerve, be guided, in investigating it, by Van der Kolk's law, 
that the sensory fibres are usually distributed in the skin corre- 
sponding to the muscles which receive the motor fibres. 

Pseudo-paralysis occurs from muscular disease, injury, in- 
flammation or degeneration, and has no appreciable central nor 
nervous lesion nor anaesthesia. 

Spasm (^Hyperkinesis) ; abnormal violent muscular contrac- 
tions with or without loss of consciousness. 

Tonic {tetanic) Spasm is violent and continuous. 

Clonic Spasm is rapidly intermittent : — Contractions and re- 
laxations. 

Tremor {trembling) consists in small,, intermittent, involun- 
tary contraction. 

Hemispasm affects the face, or limbs, or both, on one side of 
the body and may precede hemiplegia. 

Monospasm affects one limb, one group of muscles or a 
single muscle. It may be due to lesion of the brain, of the 
spinal cord or of the nerves. Thus it may imply commencing 
disease of the njoter centres or tracts. 

Spasms of the Eyeballs (rolling of globe to one side) and 
Spasms of the Eyeballs and Head, are important indications 
of apoplexy. They imply disorder (commencing irritation) of 
the cerebral motor areas. Advanced disease would probably de- 
termine hebetude, coma, drowsiness, or palsy. If epileptiform 
it turns away from the lesion. If hemiplegic it turns toward the 
lesion and away from the paralysis. If lesion of the pons it 
turns away from the lesion. 

Paraplegic Spasm is a tonic spasm, partial in degree, caus- 
ing stiff, tetanoid (spastic) walk. In all four extremities there 
may be mixed paresis and contraction. This often attends on 
hemorrhage into the meninges. 

General Spasms, convulsions as in Eclampsia, Epilepsy, 
Chorea, Tetanus. 

Local Spasms may be rhythmic or not, in slight cases to be 



General Symtamatology and Diagnosis, 5 

seen only in the eyelids or superficial muscles as twitching, and 
occur in neurasthenia, or in poisoning by strychnia, brucia and 
other motor nerve poisons. 

Incoordination {Dyskinesis) is the lack of the harmonious 
balanced movement of the various groups of muscles. Coordina- 
tion of movement is due to a special mechanism in the spinal cord, 
and extending forward through the medulla oblongata, pons, and 
crura cerebri to the floor of the third ventricle. In the form of 
ataxia (lack of power of muscular control) it is usually the result 
of degeneration (sclerosis) of the superior columns of the cord, 
of the medulla, pons or crura. It may occur from degeneration 
or destructive change in the cerebellum, or from disease or sec- 
tion of the posterior roots of spinal nerves, or finally from the 
action of certain narcotic poisons (ptomaines, toxins). 

Staggering (Htubaiion) occurs from lesions of the cerebellum, 
medulla or pons ; also from alcohol, opium, and other narcotics. 

Reflex Action . The normal stimulation of different functions, 
motor, secretory, circulatory, etc. , depends on the nerve centres 
in the spinal cord, which aVe roused into action by a centripetal 
impulse derived from a distant part. Thus the balanced contrac- 
tion of the different muscles which preserves the equilibrium of 
the body, depends on the apprehension by the nerve centres, con- 
sciously or subconsciously, of such contractions (muscular sense), 
and it is largely under the control of the will. Here three im- 
pulses act cobrdinately : ist, the afferent impulse from the mus- 
cle to the nerve centre ; 2d, the efferent impulse from the nerve 
centre to the muscle ; and 3d, the inhibitory or controlling, vol- 
untary impulse from the sensorium to the nerve centre involved. 
In another case, savory odors, sapid flavors and masticatory move- 
ments cause a free secretion from the salivary glands. Again, 
the scratching of a dog's breast causes him to move his hind limb 
as if he were himself doing the scratching. Again, the pricking 
of a limb causes the prompt, even if involuntary, contraction of 
its muscles to withdraw it from the source of irritation. 

Morbid Reflex. Reflex action may be modified in various 
ways as the result of disease or injury. It may become excessive 
from irritability of the organ from which the centripetal impulse 
starts, or of the reflex centre in the spinal cord, or of the muscle 
or other organ to which the centrifugal impulse is directed, or 



6 Veterinary Medicine, 

finally, from impairment of, or separation from the inhibitory 
centre in the cerebrum. It may be impaired or abolished from 
degeneration or destruction of any of the tissues just named, or 
of the conducting nerves which connect them to each other. 

The contraction and closure of the pupil under light is a reflex 
act from the retina on the optic lobes, etc., and from these 
through the motor oculi to the iris. This reflex is lost and the 
iris fails to contract in : anaesthesia of the retina ; atrophy of the 
optic nerve ; disease of the optic lobe ; superior (posterior) spinal 
sclerosis ; disease of the motor oculi ; or disease of the iris. 

The lumbar reflex is lost in many febrile states in the horse, so 
that pinching of the loins fails to produce wincing, and this be- 
comes a test of the active persistence of the disorder. 

Increased Reflex is often noticed when the parts, including 
the spinal reflex centre, are disconnected from the brain : as in 
lesions or disease of the cord in front (cephalad) of its reflex cen- 
tre. Here the cerebral or voluntary inhibition is lost. 

Reflex Tonic Spasm of muscles around a diseased or dislo- 
cated joint, or of those controlling its action, often affords a val- 
uable means of diagnosis, the possibility of nervous, muscular 
and tendinous disease being excluded. 



TROPHIC SYMPTOMS AND DISORDERS. 

Degenerative atrophy, in hsempglobinuria, laryngeal hemiplegia, neurec- 
tomy, nerve lesion, brain or cord lesion, lead poisoning, disuse. Dermatitis, 
ulceration, morbid secretion, polyuria, mellituria, albuminuria, poisonous 
mUk.- 

Degenerative Atrophy. From section, disease, atrophy or 
degeneration of nerves or nerve centres, the muscles, which they 
normally innervate, waste, often to an extreme degree. As ex- 
amples of this we see the atrophy of the triceps extensor cruris 
and other groups in hsemoglobinuria, of the intrinsic laryngeal 
muscles in roaring, of the muscles supplied in neurectomy, and of 
groups of muscles in myelitis, broken back, lead paralysis, and 
scapular muscular atrophy. True to the law of wasting of physi- 
ologically inert organs, the nerves are atrophied and degenerated, 
and often also the bones, joints and skin. 



Trophic Symptoms and Disorders, 7 

The degeneration of an inactiveorganapplies to the nervous tis- 
sues themselves. According to the law of Waller, the nerve fibre 
(axis cylinder), when cut ofiF from its nutritive center (cell body 
with nucleus) degenerates and ultimately perishes. The axis 
cylinder is a component part of the neurou, which includes also 
its continuation in the cell and nucleus, and when the latter, 
which is the source and origin of both nerve impulse and trophic 
control, is lost, the inactive axis of the nerve fibre degenerates. 
This law is now availed of in tracing the distribution of nerve fila- 
ments, the degeneration being found in those that have been cut 
ofiF from their nerve cells while those that come into the nerve 
trunk from other sources, distal of the injury, maintain their 
integrity. 

In addition to this peripheral atrophy, a degeneration centrad 
of the injury to the nerve is seen under certain conditions, but 
especially in intrauterine life. In such cases the atrophy may ex- 
tend up to and include the central nerve cells, causing a secondary 
central nervous lesion from an initial peripheral one. 

By bearing these laws of nerve atrophy in mind, lesions that 
would otherwise be obscure, may be satisfactorily accounted for. 

Eruptions and Ulcerations of a Nervous Origin. Herpes 
or shingles in man is now recognized as a nervous disease, cir- 
cumscribed to the distribution of given nerves and occurring 
unilaterally or bilaterally. Deep-seated dermatitis, vesicles, neu- 
ralgia, pain, itching and formication are common accompaniments. 
The whole is traced to disease of the ganglion on the posterior 
(superior) root of the spinal nerve distributed to the part. This 
establishes a principle, and in inscrutable and obstinate, circum- 
scribed skin disease the veterinarian should see if it coincides 
with the distribution of one or more sensory spinal nerves. 

Ulcerations are often caused by the lack of protection of a part 
after paralysis, thus perforation of the cornea will follow section 
or disease of the trigeminus. These may be prevented by care- 
fully covering the part, and even cured by a fine protective cover- 
ing like collodion. 

Alterations of the Secretions often follow on section of the 
sympathetic trunks, that of the cervical sympathetic in rabbits 
causing elccessive congestion of the facial skin, with exudation 
and scabby product, also profuse secretion of sweat, tears, and ear 
cerumen and dry, scaly skin. 



8 Veterinary Medicine, 

Polyuria is determined by section of one point of the medulla 
behind the root of the vagus, mellituria by puncture between the 
vagus and auditory nerves (the hepatic vaso-motor centre), and 
albuminuria by a puncture in front of the latter. Impairment of 
the hepatic vaso-motor tracts in the spinal cord, or of the anterior 
or posterior cervical sympathetic ganglia, or of the first thoracic 
ganglion equally determines nervous mellituria. 

Poisonous milk produced in hard worked mares, or over-ex- 
cited dams of other species, causing dyspepsia, diarrhoea, arthritis 
or other trouble in the suckling, must be in part attributed to 
nervous disorder. 

Practically all secretions and nutrition are largely under nerv- 
ous control, so that modifications in quantity or quality can often 
be attributed to nervous influence. 



SENSORY SYMPTOMS AND DISORDERS. 

Hjperaesthesia, cutaneous, thermic, muscular, visceral. Parsestbesia, 
pressure on nerve. Anaesthesia, partial, drug. Analgesia. Hyperalgesia. 

These are necessarily much less obvious to the veterinarian 
than to the physician of man. Yet in certain cases they may be 
observed directly, and in others deduced from dependent symp- 
toms. 

Hypersesthesia is a .state of exalted excitability of any part of 
the sensory nervous apparatus. 

Cutaneous hypersesthesia is that condition in which the 
slightest touch gives rise to an instant and extreme response. 
Some nervously organized mares which are dangerously ticklish 
and irritable, afford physiological examples. The surface sore- 
ness and sensitiveness which exist in the febrile chill, in wounds, 
dermatitis and neuralgia give pathological examples. It is further 
seen in certain cases of meningitis (cerebral and spinal), spinal 
irritations, rabies, tetanus and neuritis. 

Hypersesthesia in cold is seen in neuralgia, rheumatism, the 
early stages of many fevers (chill), in myelitis, neuritis, nerve 
injuries, and in posterior (superior) spinal sclerosis. 

Hypersesthesia of the muscles may be noted in tetanus, 
muscular rheumatism and neuralgia. 



Sensory Symptoms and Disorders, 9 

Visceral hyperesthesia io shown in many cases of spasms of in- 
voluntary muscles (colic, arrest of intestinal calculi, gall stones or 
urinary concretions), and in inflammation of serous membranes 
(pleurisy, peritonitis). 

Parsesthesia. This is a painful or morbid sensation caused 
by a lesion in the central nervous structures or in the nerves, but 
referred by the sufferer to some peripheral organ oyer which such 
centre presides. It may even be referred to an organ or part that 
has been amputated or otherwise removed. This may cause lame- 
ness of a kind to indicate suffering in a given muscle, tendon or 
joint, when the cause is purely central. In dourine, sexual acts 
are excited which have their real source in the nerve centres. 
The rabid dog snaps at imaginary flies in mid- winter, when such 
insects are only phantoms of his brain. 

Pressure on a nerve trunk induces sensations of tingling, 
vibration, formication, heat, cold, and paresis, referred by the 
mind to the part to which that nerve is distributed, and when the 
pressure is removed these sensations recede in the order in which 
they came. This may explain some occult cases of lameness. 

Itching may be a pure, persistent neurosis without any skin 
lesion. Treatment should then be addressed to the nervous sys- 
tem. 

Anaesthesia, or absence of sensation, is in its degree partial or 
complete. The latter is familiar as occurring in parts the sensory 
ner\'es of which have been cut across, also in parts the sensory 
nerve or nerve centres of which have become completely degene- 
rated. There is no response to the prick of a needle, the touch 
of a hot wire, to pinching or cutting. If the nerve remains intact 
as far as the spinal centres, reflex action may still occur, but the 
patient himself has no consciousness of this nor of the injury 
causing it. Accordingly, he makes no movement of head, ears, 
eyes, or other parts still dominated by the brain. 

In partial or imperfect anaesthesia, the response to irritation 
is less marked and may be even delayed. In some forms of cen- 
tral lesions the response to a prick may be delayed two, five, or 
ten seconds, or even more. 

Anasthesia causes awkwardness or uncertainty of movement, 
especially if the subject is blindfolded. 

Anaesthesia may be induced by medicine, as in the general 



lo Veterinary Medicine, 

anaesthesia of etherisation, or the local anaesthesia caused by the 
topical applicatton of cocaine or carbolic acid. 

Analgesia, or insensibility to pain, may be present in cases in 
which ordinary sensations are still felt. It may be caused by co- 
caine, alcohol, and to some extent by carbolic acid. 

Hyperalgesia is the opposite of this condition, and may be 
seen in certain irritable conditions of the nerve centres. 



PSYCHIC SYMPTOMS AND DISORDERS. 

Limitation in lower animals. Effects of age, training, race heredity, in- 
dividual and racial peculiarities, exhaustion, prostration, dementia, cerebral 
congestion, compression, degeneration, narcotics, ptomaines, toxins. Con- 
trolling absorption in another trouble. Delusions, hallucinations, vice, 
violence, oestrum, fatigue. Cerebral source of motions. 

These have a much more restricted field in the lower animals 
than in man in keeping with the limitation of the mental facul- 
ties, and they may often be traced to demonstrated structural dis- 
order. Yet some emotions of joy, fear or rage run very high 
and are comparatively unchecked by high mental development or 
mental training. The effect of training is, however, very 
marked in the more educated animals. 

Age modifies by the sobering that come from experience and 
habit. The frolics of puppies, kittens, lambs, foals and calves 
are in marked contrast with the sedateness and stolidity of old 
dogs, cats, sheep or cattle. 

Training is seen in the educated horse which would have 
been panic stricken at sight of a locomotive, flag or floating 
paper, at the smell of a lion or bear, at the sound of a gun or 
drum, and which will now boldly face any one of these with no 
manifest tremor. The emotional puppy can be trained to 
soberly fetch and carry, to drive sheep or cattle without biting, 
to lie sentinel by his master's property, to point at birds without 
seeking to catch them, or to carry shot birds without devouring 
them. 

Race heredity comes from the training along the same lines 
in many successive generations. Thus the more domesticated 
breeds of dogs (shepherd, poodle, and greyhound) are very af- 



Psychic Symptoms and Disorders. 1 1 

fectionate ; other breeds (bull, mastifiF, bloodhound) are lacking 
in this character. AH trained races take naturally to the occu- 
pations of their ancestors. Some (horses, cattle and sheep) are 
easily panic-stricken, (stampeded). Some (turkeys, roosters) 
are not easily stampeded. Some (skunks), having effective 
sources of defense, have little fear of man. 

Individual and racial mental dullness and torpor must 
also be recognized. Some are stupid and slow, others alert and 
quickly responsive. Some horses are not level-headed and be- 
come uncontrollable in difficult situations. Some dogs are so 
emotional as to endanger their lives from sudden heart trouble. 
Some horses, dogs and cats will pine and die when separated 
from their fellows or human friends. Extreme timidity, or 
sudden rage may be so marked as to constitute a virtual morbid 
phenomenon. Sluggish cerebral and mental action may result 
from exhaustion^ prostration^ or dementia ; also from cerebral con- 
gestion, pressure and degeneration ; or from poisoning by nar- 
cotics y ptomaines or toxins (opium, hyoscyamus, Indian hemp, 
dourine, milk sickness, etc. It may come from profound ab- 
sorption in another object, as when the rabid dog bears whipping 
without a howl. 

Delusions or hallucinations are shown in the rabid dog 
snapping at flies, or attacking his friend or master as an enemy, 
as well as in other forms of delirium. Narcotics, such as opium, 
Indian hemp, etc., ptomaines, toxins, and (in dogs) essential 
oils cause delirium by acting on the nerve centres. 

Vice in its various forms may become a genuine neurosis, the 
animal losing control of its actions. 

Violence in the form of self-defense or aggression is seen in 
mares in heat, in bulls or stallions under sexual excitement, in 
animals roused by inconsiderate whipping, or in bulls looking on 
scarlet clothing. 

Some high-spirited animals, under extreme fatigue from over- 
work, sometimes become violent but resume their docility under 
rest and food. 

In all cases we must know the normal of an individual animal 
to enable us to properly appreciate any apparent deviation from 
the psychic form. No less essential is it to take into account 
the environment and treatment of the patient. 



1 2 Veterinary Medicine. 

With regard to localization of cerebral lesions, Sequin thinks 
emotions are probably generated in the basal ganglia such as 
those of the pons and thalami, while inhibition depends on the 
anterior cerebral cortical convolutions. 



DIAGNOSIS, SYMPTOMS AND THEIR IMMEDIATE 

CAUSES. LOCALIZATION OF LESION IN 

SPECIAL SYMPTOMS. 

Spasm, pain, numbness — irritation. Paresis, paralysis, anesthesia (con- 
stant), destructive lesions. Both combined — variable symptoms, recurrent. 
Definite, fixed symptoms — structural lesions, usually progressive. Symp- 
toms, variable as to place, time, subsidence and recurrence — functional 
lesions. Brain lesions. Pressure on brain — pain, spasm, nausea, dullness, 
blindness, stupor, coma, palsy. Congestion and ansmia synchronous. 
Lesions of cortex. Encephalic lesions — hemiplegia, with spasms, increased 
reflexes, spasms follow cranial nerves, vertigo, apoplexy, epilepsy, dementia, 
coma, little muscular atrophy, or dermal sloughing. Spinal lesions, para- 
plegia, without spasm, reflex reduced or nil, follow spinal nerves, head 
symptoms less, much muscular atrophy, bed sores. Sensory and motor 
tracts, in cms cerebri, respiratory centres — inspiratory, expiratory, inhibi- 
tion. Salivation, sneezing, coughing, sucking, chewing, swallomng, vomit- 
ing. Cardiac centres, accelerating and inhibitory. Vasomotor centre. 
Spasm centre. Perspiratory centre. Pons. Corpora quadrigemini, crura 
cerebri. Thalamus, corpus striatum. Cerebellum. Cerebral cortex : in 
ass ; in dog. Spinal lesions : lateral half section : central anteroposterior, 
vertical section : superior columns ; inferior columns ; cervical lateral 
columns ; respiratory tract ; glycogenic centre ; pupillary dilator ; cardiac 
accelerator ; vaso motor, sudoriparous ; centre for anal sphincter ; for vesi- . 
cal sphincter ; genital cCntre ; vaso-motor and trophic centres ; muscular 
sense tract ; superior column and Goll's. Table of phenomena from cord 
lesions. 

In Irritation of nervous organs the symptoms (spasm, pain, 
numbness) are usually intermittent. 

In Destructive Lesions of nervous organs the symptoms, 
(paresis, paralysis, anaesthesia) are usually constant. 

When irritation and destruction are associated the symp- 
toms are variable and frequent. The characteristic symptoms of 
the two may coexist or succeed each other. 

Structural Nervous Lesions have symptoms that are definite 



Localization of Lesion in Special Symptoms, 13 

in their area of distribution, nature, (spasm, paralysis) and per- 
manency. Objective Symptoms predominate and the case is likely 
to be progressive and fatal. 

Functional Nervous Diseases have symptoms of indefinite 
distribution, variable in character, with intermissions and spon- 
taneous disappearances (as under marked excitement) and sub- 
jective sjrmptoms predomin£ite. They may, however, last for a 
length of time without change. 

Localization of Brain Lesions. 

Lesions of the cranial nerves and their superficial and deep 
centres of origin need not here occupy attention. These may be 
studied in works on anatomy and physiology. Attention may be 
drawn rather to the remoter effects of ganglia which effect or 
control distant action, and to general pressure on the encephalon. 

General Pressure on the Encephalon, whether through 
fracture of the cranium and depression of bone, by acute conges- 
tion, by blood extravasation, by inflammatory exudation, or by 
acute abscess, will cause pain, spasms, nausea, dullness, blind- 
ness, stupor and coma. After expulsion of the cerebrospinal 
fluid from cranial cavity, the increasing pressure compresses 
the blood vessels, reduces or interrupts the circulation and 
abolishes the functions in the parts deprived of blood. Thus 
congestion of one portion of the encephalon is usually associated 
with diminished circulation in another portion. Disorder in the 
first may occur from h3rperaemia and irritation and in another 
part from a consequent anaemia. 

Destructive Lesions of Cortex of One Cerebral Hemi- 
sphere may or may not cause permanent symptoms, as shown 
by the passage of a crowbar through the front of the left hemi- 
sphere, yet the man survived for 13 years and showed no loss of 
intelligence, his disposition and character alone having changed 
for the worse. The one hemisphere may by itself suflSciently 
control mental acts, while the other lies dormant or may even 
have undergone degeneration. 

Diagnosis of Encephalic and Spinal Lesions. The fol- 
lowing may be taken as guiding principles : 

Encephalic : Hemiplegic or bilaterally hemiplegic grouping 
of sjonptoms. 



14 Veterinary Medicine, 

Spinal : Paraplegic grouping of symptoms. 

Encephalic : Frequent contracture or spasms of paretic 
muscles. 

Spinal : Paralysis more perfect and continuous. 

Encephalic : Reflexes in afiFected muscles increased : Cerebral 
inhibition absent. 

Spinal : Reflex abolished or reduced in parts the seat of the 
lesion. 

Encephalic : Spasms in areas of distribution of cranial nerves 
(not spinal. ) 

Spinal : Spasms and paralysis follow distribution of spinal 
nerves. 

Encephalic : Head symptoms frequent (vertigo, apoplexy, 
epilepsy, dementia, coma). 

Spinal : Relative absence of head symptoms. 

Encephalic : Comparative absence of marked muscle atrophy. 

Spinal : Atrophy in special muscular groups. 

Encephalic : Little tendency to form bed sores. 

Spinal : Tendency to form sloughs and bed sores. 

Sensory (^sthesodic) and Motor (Kinesodic) Tracts in 

Encephalon. 

In the cms and above, the sensory tract lies dorso-laterad of the 
motor tract, forming about one-fifth of the cms, and extending 
upward through a white layer bending inward to form an angle 
and finally diverging to the different cortical convolutions. The 
motor tract is mainly contained in the inferior pyramids of the 
bulb, and constitutes the median two fifths and basal two fifths of 
the cms. Without entering farther into this subject it will be 
observed that lesions of the outer layer of the cms and its radi- 
ating fibres may cause hemiansesthesia of body or head, includ- 
ing the eye, while lesions of the median and basal layers and 
radiating fibres induce hemiplegia of the head, tongue, fore 
limb, hind limb, trunk, etc. 

Respiratory Centres, Inspiratory and Expiratory are in 
the floor of the fourth ventricle between the centres for the vagus 
and accessory nerves, and are directly stimulated by the CO, in 
the blood. Secondary subsidiary centres are in the optic thala- 
mus, in the corpora quadrigemini both anterior and posterior 



Sensory and Motor Tracts in EncephaUm. 15 

pairs, and finally in the cervical spinal cord, so that disorder of 
respiration may occur from lesions in these points as well as in 
the main oblongata centre. 

Respiratory Inhibition and arrest depend on the vagus, the 
superior and inferior laryngeal nerves. 

The Salivation Centre also lies in the floor of the fourth 
ventricle and stimulation of the medulla causes free secretion. 

The Centres for Sneezing, Coughing, Sucking, Chewing, 
Swallowing and Vomiting are also seated in the oblongata, so 
that any one of these phenomena may come from a central irrita- 
tion. In bulbar paralysis the loss of power usually extends from 
the tongue through the lips, cheeks, jaws, pharynx, larynx, to 
the respiratory muscles and heart. Coughing may be roused by 
irritation of the external auditory meatus, liver, stomach, bowels, 
or generative organs as well as from the air passages. 

Cardiac Accelerating and Inhibiting Centres are both 
present in the bulb, the latter receiving its afferent impulse main- 
ly through the vagus nerve. Stimulation of the vagi, anaemia of 
the bulb through decapitation or through tying both carotids, 
h3rperaemia through tying of the jugulars, a venous state of the 
blood, and blows on the abdomen all slow or arrest the heart 
action. Digitalis or muscarin has a similar effect. The heart 
action is accelerated by febrile and inflammatory affections, by 
a high or low temperature by section of the vagi, by sipping 
of cold water, by atropine or curari, and by salts of soda. Potash 
salts on the other hand restore the inhibitory action of the vagi 
and lower the heart's action. 

The Vaso Motor Centre is also in the oblongata and the 
contraction of the vessels with increase of arterial pressure may 
ensue from afferent currents in the sympathetic nerve and many 
sensory trunks. The varying activity is seen in blushing, in the 
congestion of mucous membranes under rage or excitement, in the 
capillary contraction in the early stage of inflammation, in the 
second stage of capillary dilation, in angioma, or nsevus, and in 
extensive congestions and haemorrhages in different organs. The 
arrest of bleeding under fainting is due largely to the anaemia of 
this centre. 

A Spasm Centre^the pricking of which causes general con- 
vulsions lies in the medulla: oblongata at its junction with the 



1 6 Veterinary Medicine. 

pons. This is excited by excess of carbon dioxide in the blood, 
by sufiFocation, drowning, by anaemia of the bulb from bleeding 
or ligature of the carotids, by venous congestion after ligature of 
the jugulars, or by the direct application to the part of ammonia 
carbonate, or salts of potash or soda. It may also be aroused by 
afferent nervous currents from different peripheral parts (spinal 
cord, sciatic nerve, etc.). 

A Perspiratory Centre is found in the medulla, on each side, 
which may be roused into action by diaphoretics (opium, ipeca- 
cuan, tartar emetic, Calabar bean, nicotin, picrotoxin, camphor, 
pilocarpin, ammonia acetate, etc.). 

The Pons like the medulla is at once a ganglionic and con- 
ducting organ, and its lesions may lead to arrest of nerve currents 
generated above or below it, or to the failure to develop currents 
in its own centres. Stimulation of its superficial layers may be 
without effect, but if this is carried into the centre epileptiform 
convulsions ensue. Lesions of one side of its posterior half cause 
facial paralysis the same side and motor and sensory paralysis on 
the opposite side of the body (crossed hemiplegia). Lesions of one 
side of its anterior half cause paralysis in both face and body on 
the same side. This depends on the crossing of the fibres mid- 
way back in the pons, which cross again in the medulla (motor 
fibres) and in the spinal cord (sensory fibres). Lesions of the 
pons are liable to interfere with the functions of the trigemini, 
the oculo motor and the superior oplique, and to determine 
epileptic movements and loss of coordination of sensorio-motor 
movements. Lesions of the superficial transverse fibres (median 
cerebellar peduncles) tend to cause involuntary movements to 
one side. 

Lesions of the Corpora Quadrigemina cause disturbance of 
vision, failure of the pupil to contract to light, blindness, paralysis 
of the oculo-motor nerves, and lack of coordination of move- 
ments. Stimulation of one anterior corpus causes rolling of 
both eyes to the opposite side, with, if continued, a similar move- 
ment of the head and even of the body (horse in mill, or index 
motion, or rolling on its axis). 

The Crura Cerebri are conducting bodies but contain also 
different nerve centres. Lesions of one cms cause violent pain 
and spasm on the opposite side of the body, followed by paralysis. 



Sensory and Motor Tracts in Encephalon, 17 

The oculo motor moy be paralyzed on the same side, but the face 
and tongue on the opposite side, owing to the fibres crossing in 
the pons. There may be turning movements. 

The Optic Thalamus transmits sensory currents to the cere- 
bral cortex. Lesions in this organ cause sensory paral>*sis on the 
opposite side o£ the body. Afferent currents that do not traverse 
the thalamus cause reflexes only. It contains one of the roots of 
the optic nerve and its destruction will impair vision. Its in- 
juries may also produce turning movements. 

The Corpus Striatum transmits motor currents originating 
in the cerebral cortex. Lesions of its interior (lenticular nucleus) 
cause motor paral3rsis and sometimes anaesthesia on the opposite 
side of the body. Electrical stimulation of this nucleus causes 
general muscular contractions of the opposite side of the body. 
Irritation of the surface layers is painless and s^rmptomless. 

The Cerebellum has been long credited with coordination, 
andPlourens, after its removal from a pigeon, found an utter lack 
of harmonized movement in walking, springing or balancing, 
Ludani removed the organ from a bitch and, after full healing of 
the part, found a lack of muscular tone (a cerebellar ataxy), so 
that no great muscular effort could be satisfactorily accomplished. 
After months, marasmus set in and proved fatal. The lack of 
coordination is especially connected with lesionsof the vermiform 
process, those of the posterior portion causing falling forward and 
those of the anterior portion, falling backward. Injury to the 
middle peduncle on one side causes turning or rolling to the 
opposite side. Under slighter injuries they may be only un- 
steadiness and staggering like a drunken man. Nausea and 
vomiting, with more or less stiffness of the neck or oposthotonos, 
may be present. Rolling of the eyes or squinting may occur. 

Focal Cortical Centers of the Cerebrum. Cortical 
Localization. Much has been done experimentally and by 
observation of morbid lesions to locate functions in the different 
convolutions, and though the subsidiary implication of adjacent 
and interdependent parts interferes with a perfectly confident 
diagnosis, yet certain fundamental facts may be borne in mind as 
contributing to a satisfactory diagnosis. 

Arloing, on the basis of his own experiments and those of his 



1 8 Veterinary Medicine. 

predecessors, gives the following as applicable to the equine (ass) 
brain : 

1. Stimulation of the origin of the front part of the first frontal 
convolution, or of the anterior part of the pre-Sylvian convolu- 
tion, causes approximation of the feet on the opposite side of the 
body. 

2. Stimulation of the superior part of the first frontal convolu- 
tion or of the superior part of the post-Rolandic convolution 
causes closure of the jaws and diduction. 

3. Stimulation of the anterior end of th£ upper orbital convo- 
lution, or of the anterior part of the pre-Rolandic convolution, 
leads to movements of the nose and upper lip. 

4. Stimulation of the antero-superior part of the lower frontal 
convolution, or the union of the post-Rolandic with the Sylvian 
convolution causes movement of tongue and jaws. 

5. Stimulation of the union of the vertical and horizontal parts 
of the orbital convolution or frontal lobe, causes opening of the 
jaws and bending of head and neck. 

6. Stimulation in the front of the union of the frontal and 
longitudinal convolutions, or at the union of the Sylvian and sec- 
ond parietal convolution causes rolling of the opposite eye. 

7. Stimulation of union of the frontal and parietal parts of sec- 
ond parietal convolution leads to closure of both eyelids or, with 
a strong current, of lids on both sides. 

8. Stimulation of the second parietal convolution, above and a 
little behind the extremity of the Sylvian fissure, causes opening 
of the eye and adduction of the ear on the opposite side, or, if a 
very strong current, on both sides. 

9. Strong stimulation of the posterior part of the first and sec- 
ond parietal convolutions causes tonic convulsions. 

ID. Currents through the posterior parts of the third and fourth 
parietal convolutions give similar convulsions with violent trem- 
bling of the trunk and members. 

In the Dog's Brain localization is easily made by reference to 
the crucial fissure which passes outward, right and left, at right 
angles with the longitudinal fissure about the junction of its 
anterior with its middle third. Also by four parietal convolutions 
which run backward from near the crucial fissure, parallel with the 
longitudinal fissure. They are counted from without inward. 



Sensory and Motor Tracts in Encephalon, 19 

Fritsch, Hitzig and Ferrier have mapped out the following motor 
areas : 

1 . The convolution in front of the outer end of the crucial sul- 
cus controls the muscles of the neck. 

2. The bend of the same convolution backward, opposite the 
outer extremity of the crucial sulcus, controls the extensors and 
adductors of the fore limb. 

3. The convolution just behind the outer end of the crucial 
sulcus controls the muscles which flex and rotate the fore limb. 

4. The same convolution behind the middle of the crucial fis- 
ure controls the movements of the hind limb. 

5. The second convolution back of the crucial fissure controls 
the muscles of the face. 

6. The anterior part of the internal (4th) parietal convolution, 
just back of the crucial fissure, controls the lateral switching 
movements of the tail. 

7. The posterior angle of the first post-crucial convolution 
causes retraction and abduction of the fore limb. 

8. The outer end of the first post-crucial convolution, directly 
behind the outer end of the sulcus, causes raising of the shoulder 
and extension of the fore limb. 

9. The anterior end of the third parietal convolution (the 
second from the longitudinal fissure) controls closure of the eye- 
lids, the rolling of the eyeball upward, and narrowing of the 
pupil. 

10. Stimulation of the anterior end of the second parietal con- 
volution causes partial opening of the mouth with retraction and 
elevation of its angle. 

11. Stimulation of the point of union of the first and second 
parietal convolutions anteriorly causes opening of the mouth 
with protrusion and retraction of the tongue. 

12. Stimulation of the median part of the second parietal con- 
volution, causes retraction and elevation of the angle of the mouth. 

13. Stimulation of the convolution directly in front of the 
outer end of the crucial sulcus causes dilatation of the eyelids 
and pupil while the eyes and head are turned toward the oppo- 
site side. 

14. Stimulation of the convolution behind the crucial fissure 
causes contraction of the muscles of the perineum. 



20 Veterinary Medicine. 

15. Stimulation of the convolution in front of the crucial fis- 
sure, on its anterior and sloping portion, causes movements of 
the pharynx and larynx (swallowing). 

16. Stimulation of motor areas of the cortex, by scraping, irri- 
tation, or disease tends to produce spasmodic contractions of cer- 
tain groups of muscles (Jacksonian Epilepsy). Strong stimula- 
tion may cause general epileptiform spasms, which are at first 
tonic, then clonic. One such seizure strongly predisposes to a 
second. If, during an attack, the cortical centres presiding over 
a special group of muscles were sliced off, such muscles relaxed, 
though tlie general spasms in the other muscles continued. 

Lrocalizations of Spinal Lesions. 

Being at once a conductor between the brain and nerves, and a 
reflex nerve centre, we must consider both roles in seeking to 
locate lesions from sjrmptoms. In passing from the nerves to 
and from the sensorium both sensory and motor currents cross so 
that one side of the brain presides over the other side of trunk 
and limbs. This crossing of the motor fibres takes place in the 
medulla oblongata, while that of the sensory fibres occurs in the 
spinal cord close in front of the nerve from which they have 
entered. 

Cross-Section of one lateral half of the spinal cord 
therefore causes motor paralysis and rise of temperature of the 
whole of that side of the body posterior to the lesion, while it in- 
duces sensory paralysis and cooling on the opposite side of the 
body up to the same point, A very limited sensory paralysis on 
the same side occurs corresponding to the few sensory fibres pass- 
ing outward obliquely through the portion injured by the cross- 
section. 

A vertical section of the cord separating the one lateral 
half from the other does not necessarily affect the motor cur- 
rents, while it produces a limited anaesthesia on each side in the 
area of distribution of the nerves, the sensory fibres of which 
crossed in the seat of the lesion. 

Transverse section of the superior columns causes hyper- 
sesthesia and lack of coordination. 

Transverse section of inferior columns, or of the in- 
ferior horn of gray matter, if close behind the medulla, causes no 



Locaiizaiicm of Spinmi Ltsioms. at 

motor paral3rsis, but if farther back induces motor pand>*sis on 
the same side of the body. 

Transverse section of the cervical lateral columns causes 
motor paralysis of the lateral walls of the chest (respiratory 
tract). If the section is mad^ in the dorsal or lumbar region it 
is the same as lesion of the superior columns. 

Among reflex centres in the cord the following may be named : 

The Respiratory Tract in the cervical lateral columns just 
referred to. 

A Glycogenic Centre in the anterior cervical section be- 
tween the bulb and the fourth cervical nerve. 

Centres vrhich Dilate the Pupil between the fifth cervical 
and the sixth dorsal nerve. 

Cardiac Accelerator Centres between the three last cer\*ical 
and the five first dorsal nerves. 

Vaso-Motor Sudoriparous Centres in the central gray 
matter. 

Centre for Anal Sphincter between the sixth and seventh 
dorsal nerves. 

Centre for Vesical Sphincter between the third and fifth 
lumbar nerves. 

Genital Centre, opposite the first lumbar nerve. 

Vaso-motor and Trophic Centres are found in the inferior 
horns of gray matter, and their degeneration causes progressive 
muscular atrophy. 

The Muscular Sense Tract is located near the surface of 
the superior columns, so that a certain amount of incoordination 
and unsteadiness of progression follows its destruction. 

The Deeper Part of the Superior Columns and the Column 
of GoU which bounds the superior median fissure control mus- 
cular sense and coordination, and their disease (posterior lateral 
sclerosis) entails locomotor ataxy. 



22 



Veterinary Medicine. 



TABLE SHOWING PROMINENT PHENOMENA PROM LESIONS 
OF THE CORD. 



LB8XON8 IN 



Cervical Rcaion. 



Doraal Region 



LumtMir Region 



paralysis in 
Sensation 

Atrophy . 
Blectric reaction 

Bladder 



Bowels 

Superficial reflex 
Deep reflex 
Priapism 



Neck muscles ; d i a 

phragm; trunk 

limbs. 
Local hypenesthesia in 

fore limbs. Aneesthe- 

sia in rest of limbs 

and trunk. 
Rare in neck ; common 

in fore legs. 
Lessened in atrophied 

muscles. 



Retention or intermit- 
tent incontinence re- 
flex, or (later) from 
overflow Cystitis 
common. 

Involuntary evacuation 
(reflex spasm) or con- 
stipation. 

Temporary loss ; then 
rapid increase. 

Temporary loss ; then 
slow increase. 

Often present 



Dorsal,abdominal and 
intercostal muscles. 
Paraplegia. 

HyperKStnesiain low- 
er part of abdominal 
walT 

Slight in muscles be- 
hind lesion. 

Lessened in dorsal 
and abdominal mus- 
cles ; slightly in 
wasted leg. 

Same as cervical. 



Same as cervical. 

Same as cervical. 
Same as cervical. 
Often present. 



Paraplegia. 



Hyperaesthesia in 
zone around loins : 
aneesthesia in hind 
limbs. 

In hind limbs. 

Lessened in atrophied 
muscles ; in ratio. 



Incontinence f r om 
palsy of sphincter. 



Paralysis of sphincter 
with incontinence ; 
costiveness. 

Lost. 

Lost. 
Absent. 



k 






HALLUCINATIONS. 



Subjective cerebral impressions projected as real. 
Poisons. Essential oils. Chloroform. 



Rabies. Toxins. 



Hallucinations are subjective impressions which the animal 
supposes to be real. The disorders in his brain are projected out- 
ward and become to him real objects and occurrences. 

They may arise from the presence of proliferation of microbes 
in the brain as in rabies in animals. They may proceed from poi- 
soning of the brain by toxins as in anthrax. 

They may be developed, in dogs especially, by the action of cer- 
tain essential oils on the cerebral cortex. The first two classes 
will be considered with those special diseases. The mental dis- 
orders from drugs have been studied experimentally by Cadeac 
and Mennier, and may be noticed in this place. 



Timidity. Panic. Stampede. 23 

Lavander, fennel and angelica produce in the dog a condition 
of extreme terror, and overcome all disposition to exercise self- 
defense. 

Mints and origanum induce hallucinations of odor. The dog 
seeks around with head and nose elevated, sniffs the air, moves 
cautiously, fixes his eye on some phantom object, and starts to 
hunt imaginary game. The love of catmint seems to amount to a 
mania in the feline animal. 

Kidney vetch evidently causes a sensation of itching or formi- 
cation ; the dog bites the hair of the tail, the hind limbs or the 
flank as if to destroy fleas or other vermin. 

Dogs under chloroform have sought to hunt, and stallions un- 
der ether have shown generative excitement with erection of the 
penis and movements of coition. 



TIMIDITY. PANIC. STAMPEDE. 

Timidity. Panic. Timid driver. Impaired vision. Nervous. Irritability. 
Gaddiofr. Gregariona habit. Absence of natural weapons. Treatment. 
Habit Snbstitiition. Absolute constraint Kindness. Boldness. Work. 
Moderate diet 

An animal is naturally nervous, and by habit has become timid 
until it is virtually impossible to utilize it. In a body of animals, 
fear is quickly transferred from one to the other until all join in 
a wild panic and stampede. This is common in range cattle or 
horses, but is found in army horses as well, and a whole regiment 
will sometimes refuse to longer face the enemy and flee in spite of 
every effort of the rider. On a smaller scale, two timid horses in 
a team, scared by some unusual sight, add each to the sense of 
fear of the other, as they try to escape, until they gallop blindly 
into any danger. This sense of terror is often fostered by the 
timid rider or driver, every feeling of apprehension conveyed 
through the trembling or tmcertain hand, or the voice which has 
lost the element of confidence, tending to undermine the last ves- 
tige of^trust on the part of the horse. Imperfect sight is one 
cause of panic, as the perception of common objects in distorted 



24 Veterinary Medicine, 

form or unwonted situations strikes terror to the timid animal, 
causing shying or bolting. Better absolute blindness than such 
imperfect vision. 

A constitutional timidity tends constantly to increase unless the 
animal is judiciously accustomed to the object of terror. The 
horse once scared, seems to become more and more watchful for 
other objects of dread, and even inclined to bolt from such as are 
common and of every day occurrence. 

Cattle and sheep attacked by the gadfly (oestrus) flee in great 
terror, and this dread is communicated from animal to animal so 
that the whole herd or flock is suddenly panic-stricken. The bel- 
low of the ox attacked and the erection of its tail is the signal for 
every other within reach to join the stampede. 

These panics are associated with the instinct of these races to- 
ward a gregarious life ; they mass together for protection and 
they learn to heed the slightest indication of approaching danger. 
This instinct grows more powerful by constant exercise, and is 
most marked in those genera which have the least natural means 
of protection. Hence, of all animals sheep are most easily panic- 
stricken, and once affected, they move in mass, one following its 
fellow, without object, without definite direction or destination, 
and without consideration of the other dangers they are to meet. 
Hence, if one sheep jumps over the parapet of a bridge to certain 
destruction, the whole flock speedily follows. If one leaps over a 
fallen tree into a snow bank, all at once follow suit and pile above 
each other in one suffocating, perishing mass. 

While this condition is hereditary in gregarious families, it is 
essentially a psychosis in those animals that have been often 
scared until they are continually on the watch foi objects of fear. 
Treatment. In the case of horses, the best course is to make 
the animal familiar with the object of dread ; let him look at it, 
approach it siowly, smell it, feel it with his lips. Never turn 
away his eyes from it and drive him off, as that confirms the im- 
pression of dread, and the object retains ever after its dreaded 
appearance. In this way timid colts become gradually fearless of 
umbrellas, city sights, street cars, large vans, flags, music, loco- 
motives and the like, — they become, in the expressive language of 
the horseman, road-wise, A paddock or yard beside a railroad 
will'soon accustom a timid horse to the cars, and so with other 
things, experience will remove apprehension. 



Timidity, Panic, Stampede, 25 

A more speedy reilioval of the habit of dread may often be 
secured by the principle of substitution. The mind of the animal 
does not readily attend to more than one matter at a time ; if, 
therefore, we can distract the attention in another direction, the 
object of fear may be virtually ignored until the eye has become 
habituated to it, and it will be recognized as harmless. Thus it is 
that a twitch on the upper or lower lip, a binding of the chin in 
upon the breast by a Yankee bridle may make the horse tempo- 
rarily heedless of the object of terror. So also in the bolting 
horse, the obstruction of the breath by a cord with a running 
noose around the neck, or the sending of an electric current 
through wire reins and bit will promptly check him in his wild 
career. 

The result is still better when the animal is made to feel his 
utter helplessness in the hands of man and the futility of any at- 
tempt to escape. On this are based the method of Rarey and of 
his various successors. With fore limbs strapped up, the animal 
soon exhausts himself in his efforts to disengage them and escape, 
and lies down completely reconciled to his fate. He may now be 
accustomed to his objects of terror — the opening and closing of 
an umbrella, or the waving of a flag over his head, the discharge 
of a gun close to his ear, the passing of car or locomotive, or any 
other object of his dread. When allowed to get up he will usu- 
ally pay no further attention to these things, especially if patted 
and spoken to encouragingly, and perhaps fed apple or sugar, or 
something of which he is fond. As far as is consistent with the 
thoroughness of the subjection, the animal should be treated 
throughout with the greatest kindness, so as to retain and even 
increase his trust in man and sense of dependence, while at the 
same time he is strongly impressed with the futility of resistance 
to his will. After the animal has been thus taught to bear with 
equanimity his former objects of terror, he should not be at once 
allowed to forget them, but by daily experience he should be con- 
firmed in the conviction that they are harmless, and may be met 
with safety. This should be carried out, if possible, in the hands 
of the bold and kind operator who has trained him, as, if returned 
to a timid driver or rider, he may be easily lead back into his for- 
mer habits of blind terror. A similar and even easier resort is the 
process of turning as given under balking. 



26 Veterinary Medicine. 

Constant hard work, for a time, is an excellent form of acces- 
sory treatment, as the plethora developed by over-feeding and 
temporary idleness begets an irritability and impatience of control 
which is quite likely to beguile him into his old habits. 

In case of runaway, beside the electric and asphyxiating treat- 
ment already referred to, the animal may be blinded and quickly 
brought to a stand-still. Movable blinds may be used which 
habitually stand well out from the eyes, but which may be instant- 
ly drawn closely over them by the simple pulling of a cord. The 
sudden darkness and the impossibility of directing his course, 
brings an instant realization of the existence of other dangers be- 
side the original bugbear. 



BALKING. RESTIVENESS. 

Definition. Common in asd and mule. Causes : low condition ; overload- 
ing ; nervousness ; sluggish nature ; irritable driver ; shbnlder sores ; poor 
collar ; hard bit : sharp or sore maxilla ; sores in angle of mouth ; mares ; 
racial tendency : going from stable : a psychosis. Symptoms : stands stock 
still ; plunges, but won't draw ; will stamp, bite, kick, rear, buck, crowd on 
wall : lie down. Breach of warranty ; sound price ; willfulness ; balking of 
raw horse ; diagnosis from nervous disorders ; sores, etc. Time in which re- 
turnable. Treatment : preventive, curative ; distract attention ; cord on ear : 
whiff of ammonia or capsicum ; closing nostrils ; blindfolding ; tying up the 
fore leg ; stroking nose, eyes or ears ; tapping flexors or metacarpus ; move 
in circle with head tied to tail ; coax to go. 

In general terms this has been defined as a refusal to obey. 
Usually in solipedsit is a refusal to move as directed with a load, 
under the saddle, or in hand. Though essentially a vice, it may 
become such a fixed habit that it appears to dominate the will of 
the animal and may thus be called a psychosis — a mental infirm- 
ity. 

It is much more common in asses and mules than in horses, in 
keeping with their more obstinate disposition and too often 
harsher treatment. 

There may be simple refusal to pull. This often comes from 
overloading, and especially when the animal has been sick or 
idle, and comes back to work with soft flabby muscles unequal to 



Balking, Restiveness, 27 

any violent exertion. After one or two ineffective efforts he sets 
himself back in the harness refusing to try again and the vice is 
started. Ordinary loads on bad roads full of holes from which it 
is impossible to drag the wheels have a similar effect. The dan- 
ger is greater if the animal is naturally of a nervous or impatient 
disposition, and if he makes a desperate plunge forward and fails 
at once to move the load. Such a horse hitched with a slow 
steady mate is liable to have expended his effort before the latter 
has had time to join him in the pull, and it becomes impossible to 
move the load because the two cannot be started simultaneously. 
The conditions are aggravated if the driver is irritable and by 
voice and acts further excites the already too excitable animal. 

Lesions of various kinds, such as shoulder bruises, abscesses, 
abrasions and callouses, saddle bruises, callouses, abscesses or fist- 
ulae cause acute pain whenever the effort is made, and render the 
animal more impatient and indisposed to try again. 

Too small a collar or one that fits badly (too narrow, uneven) 
has often a similar effect. 

Among other causes may be named a hard bit harshly used, a 
sharp edge of the lower jaw bone where the bit rests in the inter- 
dental space, sores of the buccal mucous membrane in this situ- 
ation, and caries or necrosis of the superficial layer of the bone. 
Also chaps, ulcers, or cancroid of the angle of the mouth. 

Young horses, that are as yet imperfectly trained, are more 
readily driven to balk than old trained animals. 

Mares are more subject to the vice than geldings, by reason 
apparently of a more nervous disposition, but much more because 
of the excitement to which they are subjected, under the periodic 
returns of heat. 

Peuch speaks of rare hereditary cases in which the habit is 
uncontrollable and the animal incurable. 

Friedberger and Frohner accuse chestilut and sorrel horses as 
being especially liable to balk. 

However started the continued exercise of the act fixes it 
as an incurable habit a virtual psychosis. Yet the inclination 
of the animal, his likes and dislikes to a certain extent con- 
trol its manifestations, thus a horse rarely balks in going home, 
and shows it mostly in going in the opposite direction, and 
above all on a new or unknown road. 



28 Veterinary Medicine, 

The Symptoms vary greatly in difiFerent cases. One animal 
stands stock-still propping his legs outward and absolutely re- 
fusing to budge. This may occur even in the stall when it is 
attempted to take the animal out. When on the road he is 
usually willing to turn and go back, but no persuasion by voice 
or whip can force him forward. 

Other horses make ineflFective plunges forward but never throw 
weight enough into the collar to overcome any resistance. 

Still others stamp, bite, throw themselves to one side rather 
than forward, rear up, strike with the fore feet, and if whipped 
kick with the hind. Some will throw themselves down and 
struggle in this condition. 

Under the saddle the animal may crowd against a wall, rear, 
kick, buck or even throw himself down in his efforts to dis- 
lodge the rider. These violent manifestations however rather 
belong to vice than mere balking. Trembling, perspiration, 
frequent rejection of urine, and general acceleration of pulse 
and breathing may manifest a severe nervous disorder. 

Diagnosis, It is often important to pronounce upon the exact 
nature of this trouble so as to determine whether the seller is 
responsible for a breach of warranty given or implied. As regards 
implied warranty a sound price for au animal sold to do a given 
kind of work implies a mutual understanding that the animal is 
not physically or psychically incapacitated for such work. 

The balking horse is one that obstinately refuses to perform 
a piece of work for which his physical condition seems to be well 
adapted. The willfulness of the refusal is the important feature. 
In case of such a serious drawback to the value of a horse, the 
presumption of fraud on the part of the seller is unavoidable, in 
case he failed to mention the habit to the purchaser, but of course 
this is even more emphatically certified if he has warranted the 
animal as a good worker; or kind^ or true in work. 

On the other hand he cannot be held responsible for the fail- 
ure to perform an act in case the horse has been overloaded when 
fat or out of condition, or if he has sores on back, withers or 
shoulders, a badly fitting collar, a severe or large clumsy bit, or 
sores on the lower jaw, or indeed any temporary physical in- 
firmity, to which the balking can be fairly attributed. 

Balking is not to be confounded with nervous affections 



Balking^ Resttveness, 29 

(paretic, spasmodic, congestion) in which the failure to obey is 
not due to lack of will, but to lack of power. Nor must it 
be confounded with the inability of the paralysis of lead pois* 
oning. It is perhaps most likely to be confounded with that 
lack of both sensory and motor power which attends on ven- 
tricular dropsy and other chronic affections of the brain. In such 
cases (immobility, coma) the habitual dullness, drowsiness, gen- 
eral hebetude, and lack of energy contrasts strongly, with the 
strength, vigor and general life of the animal which suddenly, 
willfully and incorrigibly balks. 

The balky horse which has no such nervous disorder as an ex- 
cuse, no badly fitting harness, no lesion on shoulder, back, limbs 
nor mouth, no unsuitable bit, no special softness nor poverty of 
condition, no slow, ill-adjusted mate, no impatient driver, and no 
excessive load, nor impassable road, but which jibs without ex- 
cuse, as a willful disobedience, may well be cause for annulling 
a sale. In most European countries such a horse can be returned 
to the seller and the sale set aside within 3 dajrs (Austria), 4 
days (Prussia), 5 days (Saxony), 9 days (Hesse). 

Treatment, This should be preventive by avoiding the 
various causes above enumerated, for if the habit is once con- 
tracted it is too often impossible to establish a permanent cure. 
The horse is largely a bundle of habits and the first act of dis- 
obedience has given a bias to the nerve cells of the cortex cerebri 
which like a planted seed tends to reproduce itself whenever an 
opportunity offers. With ever>'^ successive act of the kind, the 
impression on the nerve cells becomes deeper and more indelible 
and the habit fixed the more firmly. 

In slight recent cases in the milder dispositions the vice may 
be overcome by some resort which engages and engrosses the 
animal's attention. Among these may be named t3dng a cord 
round the root of the ear and tying it down ; giving an inhala- 
tion of ammonia or a sniff of powdered capsicum ; closing the 
nostrils until the horse struggles to breathe ; blindfolding for a 
few minutes ; t)ang up one fore leg until thoroughly tired ; even 
stroking the nose or ears until the fret is overcome. Immedi- 
ately following on any one of these methods, move the horse 
gently to the right and left and call him confidently to get up. 
Some will start if gently tapped with the toe below the knee 



30 Veterinary Medicine. 

until the foot is lifted and repeating this a few times in succes- 
sion, then, after a few steps, reward with an apple, sugar or 
piece of bread, and don't push too far at a time but repeat the 
lesson often. If among the first exhibitions of the vice it 
may be met by occupying the time in a make-believe fixing of 
the harness until the animal ceases to fret, then standing by his 
head, tap him on the croup with a whip and call him to go on. 
Or he may first be moved to the right and left and then ordered 
to move. A rather wearisome treatment is to place in the stall 
with a man behind him who taps him on the rump every few 
minutes, preventing composure, rest, or sleep, and keeping this 
up without interval for twenty-four hours or even double that 
time if necessary. If he goes well when hitched, he is driven 
but if he balks, he is returned to the stall and the treatment con- 
tinued. 

Magner, who mentions all these methods, reserves his highest 
commendation for the method of tjdng the horse's head round to 
his tail and letting him turn in a circle until he is giddy and falls 
over. Some stubborn cases get habituated to turning in one 
direction and continue obdurate until the head and tail are tied 
around on the other side and the rotary motion reversed. 
When thoroughly dazed by this treatment, the animal is hitched 
up and will usually move on. If there is still an indisposition, 
stand by his head and tap the croup with a whip, calling on him 
to start. Or subject him to further rotary treatment. 



DELIRIUM. 



A phenoDieiioii in different morbid states ; cerebrml hypi rsemia, ansemia, 
congestion, inflammation, intoxication, toxin poisoning. Symptoms : horse, 
ox, sheep, swine, dog. Treatment : adapted to primary disease present, 
narcotic, poison, and to degree of violence. Anaesthetics, soporifics, cerebral 
sedations, cold to head, eliminants,* depletion or tonics and nutritious food. 

Delirium or derangement of emotional or mental functions is 
usually the result of organic disease of the brain and especially of 
the cortical gray matter of the cerebrum. It is seen in hyperae- 
mia, anaemia, faults of nutrition, intoxications and variations of 



Delirium. 31 

temperature. The derangements of circulation may be in the 
meninges or in the nervous substance. ,The intoxications may 
be with mineral (lead, mercury), vegetable (opium, Indian hemp, 
belladonna, hyoscyamus, stramonium, strychnia), or other 
poisons, including the toxic products of microbes (as in pneu- 
monia, scalma, rabies, influenza, Rinderpest, milk sickness, 
Texas fever, etc.). 

Symptoms, These are usually an extraordinary and disorderly 
nervous excitement. Horses take expectant or ready positions 
of the limbs, plunge with feet in rack or manger, rear, turn, kick, 
bite, spring violently, neigh, and push or knock the head against 
the wall. Cattle bellow in a loud or frightened manner, attempt 
to kick and gore, grind the teeth and make movements of the 
jaws, froth at the mouth, dash themselves in any direction heed- 
less of obstacles, push the head against the wall breaking teeth or 
horns, and moving heedlessly against fences, or trees, or into 
water or pits even to their own destruction. Sheep stamp the 
feet, butt, bleat, work the jaws, grind the teeth, leap, and move in 
a given direction regardless of obstacles. Pigs grunt, tremble, 
champ the jaws, run against obstacles, scratch the ground with 
their feet or snout and creep under the litter. They may even 
attempt to bite. Dogs are restless, whine, move in a circle, snap 
at straw, bars, doors, and other objects, and may show a disposi- 
tion to bite. In all the domestic animals these delirious S3anp- 
toms may closely resemble those of rabies. This has been par- 
ticularly noticed in certain forms of poisoning. Pascault has 
found this in cattle that had eaten garlic and Cadeac in dogs that 
had eaten tansy. 

The animals in such cases become morbid, dull, taciturn, they 
become usually hypersensitive, sometimes hyposensitive, have a 
change of voice, and show a readiness to resent and bite if inter- 
fered with, and even to wander away by themselves as in rabies. 
On the other hand they may be siezed with lethargy and torpor 
as in dumb rabies, and with or without access of convulsions may 
pass away in a condition of paralysis. 

Among other conditions these symptoms have been found to be 
associated with epilepsy, foreign bodies in the pharynx, gullet, 
stomach or bowels, with intestinal parasites, or with mycotic 
poisoning (ergotism, smut, the fungus of coniferous trees, etc.). 



32 Veterinary Medicine, 

The lack of the extreme hyperaesthesia and excitability of 
rabies, and usually of the mischievous disposition to bite, the 
presence of foreign bodies in the mouth or gullet, and the evi- 
dence of disorder of digestion, with costiveness, tympany, and 
tenderness, and the history of the case may serve to differentiate. 
In cases of doubt the innoculation of a rabbit on the brain should 
demonstrate the absence of rabies by the absence of the charac- 
teristic symptoms after sixteen days. 

Treatment, As delirium in animals is a deranged innervation 
from congestion, narcotic drugs, ptomaines, etc., it must be 
looked on as in most cases a mere phenomenon, pointing to a 
definite disease, or to a particular intoxication, and treatment 
must be directed toward the removal of the primary cause. Thus 
the remedial measures must be directed in the different cases to 
the encephalitis, meningitis, digestive disorders, contagious dis- 
ease, or drug to which the affection may be traced. The patient 
must be put in a strong inclosure or securely tied so that he can 
do no harm : it will often be desirable to secure shade or cool air, 
or to apply cold water or ice to the head, and to quiet the nervous 
excitement by inhalations of chloroform, or ether, rectal injec- 
tions of chloral, or bromides, or full doses of hyoscine, sulphonal, 
trional or tetronal. These may be pushed to the extent of induc- 
ting anaesthesia, sleep or quiet, as the case may be, and meanwhile 
other measures should be taken to eliminate the poisons, correct 
the congestion, or remove the source of irritation. Anaemic 
oases may demand iron and bitters, with an aliment rich and 
easily assimilated, while plethoric cases may require purgation, 
diuresis or even bloodletting. All noise and any cause of excite- 
ment must be carefully guarded against. 



VICIOUSNESS. AGRESSIVE VICE. 

Subject malicioiuly nsing its natural weapons. Horse kicks, bites, crowds 
against wall, rears, bucks, plunges, treads upon. Cattle use horns or fore- 
bead, or kick. Dog bites. Cats scratch and bite. Ticklishness different 
Developed or inherited. Revenge. Desperation in pain. Sexual. A 
psjrchosis. Responsibility of owner, in selling, toward employe, in exposing 
in a public place. Treatment : remove source of suffering, treat kindly, 
secure confidence, castrate, place under abfolute constraint, throw a la 
Rarey^ Comanche bridle, tie head to tail and circle, etc. 

This word is employed to cover only those forms of vice in 
which the animal shows a malignant disposition to attack or in- 
jure man or beast. Each animal uses its natural weapons accord- 
ing to the occasion. 

The horse strikes with his fore feet, kicks with his hind, bites, 
crowds his rider's legs against a wall, or his attendants* body against 
the side of the stall, rears, bucks, plunges, or treads his victim 
tmder his feet. 

The ruminants, large and small, use their horns, and cattle 
their feet as well. In the absence of horns they still use the fore- 
head, but much less effectively and usually only with the purpose 
of defence. 

The dog attacks with his teeth and the cat with her claws by 
preference, and uses the teeth as a secondary weapon. 

Sv^ine use their tusks to rip or disembowel their adversary or 
victim. 

A very ticklish horse cannot bear to be touched on the flank or 
hind parts, without throwing the ear backward, glancing back, 
showing the white of the eye, and lifting the foot. But if this 
is mere excess of sensitiveness and begets no disposition to kick 
it is not viciousne&s. 

The vicious horse will in such cases bite or kick repeatedly and 
with well directed purpose. He will moreover show the move- 
ments of ears and eyes and attack his victim in the absence of 
any such excuse, the simple approach being a sufficient occasion. 
He will bile and strike with the fore feet at the same time, or he 
may strike out with one hind foot or with both at once. He may 

3 33 



34 Veterinary Medicine, 

attack indiscriminately all who approach him, or reserve his ill- 
will for particular individuals, and then he often acts under a 
feeling of revenge for ill-usage from this individual or some one 
he conceives him to represent. 

In some cases viciousness is inherited and certain families have 
a bad reputation in this respect. It may be either a survival of 
the ancestral disposition of the wild horse, or it may be a trait 
developed by ill-usage of a team of more immediate ancestors. 

In other cases the habit is acquired by the individual himself, 
and in such cases it may be due to brutal treatment at the hands 
of man ; to a continuous punishment of a high-spirited horse 
leading to resentment and retaliation ; to acute pain in boils, 
abrasions or other sores in the root of the mane, or the shoulder, 
or the back, where pressed on by the collar or saddle.; or to the 
generative excitement of mares in heat. In many such cases the 
vice lasts only during the persistence of the cause, in others it 
becomes permanent. The stallion is much more disposed to 
aggressive vice than the gelding. 

Whether we may consider the vice a disease or not, it becomes 
a habit engrained in the nature, the nerve centres tending to re- 
produce their habitual acts indefinitely, so that we may look on 
the condition as* a psychosis which is too often incurable. 

Responsibility of the ov^ner.. Dangerous aggp-essive vice is 
too self-evident to the buyer to constitute a good cause for an- 
nulling a sale, but it has this legal bearing, that the owner who 
keeps an animal known to be vicious, renders himself responsible 
for whatever injury to man or beast he may perpetrate. Thus 
the vicious stallion, bull or dog in a public place which damages 
person or property, renders his owner liable to the extent of such 
damages. This, of course, must be largely qualified by the at- 
tendant circumstances. The man employed to take care of a 
horse, knows his babits as fully as the owner, takes his chances 
and should exercise due precautions to avoid danger. The per- 
son who enters a stall carelessly without speaking to the horse, 
seeing that he stands over, or otherwise responds to his call, is 
himself to blame if he gets kicked. The attendant who does 
things to a dangerous or questionable horse for mere bravado 
cannot blame the owner if he gets himself injured. If a person 
teases a horse so as to tempt him to retaliate, not only is he re- 



Vtdousness, Ag^essive Vice. 35 

sponsible for his own consequent injuries, but largely also for 
the habits of the horse and for such injuries as others may sub- 
sequently sustain from him. 

A dog or a bull shown in a public place, and which breaks 
loose and injures spectators or others, manifestly renders his 
master responsible for all such damage. 

Treatment of aggressive vice. In mild dispositions in which 
the vice is roused by temporary suffering, it may often be cured 
by removal of the cause of such suffering. Indeed, without the 
healing of sores under the collar or saddle the vice cannot be ar- 
rested. Considerate and gentle treatment, too, will go far to re- 
store confidence and to gradually do away with the aggressive 
disposition. 

In wicked stallions castration will usually restore to a good 
measure of docility. The exceptional cases appear to be those 
that are hereditarily and constitutionally vicious, or in which the 
habit has been thoroughly developed and firmly fixed by long 
practice. 

Mares, too, which become vicious and dangerous at each re- 
currence of oestrum, can usually be completely cured by the re- 
moval of the ovaries especially if this is done early in the disease. 

The inveterate cases may usually be subdued and rendered 
controllable for a time by one of the methods of subjugation em- 
ployed by the professional tamers, but unless they are thereafter 
kept in good hands they are liable to relapse into the old habit. 
Among the more effective methods are the Rarey mode of throw- 
ing which may be repeated again and again until the animal is 
thoroughly impressed with a sense of the domination of man and 
the futility of resistance ; the resort of tying the head and tail 
closely together and letting the animal weary and daze himself 
by turning in a circle, first to one side and then to the other ; 
the application of the Comanche bridle made of a small rope, one 
loop of which is passed through the mouth and back of the ears 
and drawn tightly, then another loop is made to encircle the 
lower jaw, and the chin is drawn in against the trachea by 
passing the free end of the rope round the upper part of the neck 
and again through the loop encircling the lower jaw and draw- 
ing it tight ; or a similar small rope is passed a number of times 
through the mouth and back of the ears and drawn tightly so as 



36 Veterinary Medicifie, 

to compress the medulla and stupefy the animal. This is supposed 
to be rendered more eflFective by passing one turn each between 
the upper lip and gums and between the lower lip and the gums. 



CATALEPSY. 



Definition. Tetanic and paralytic forms. Balance of flexors and extensors 
Cataleptoid. No constant lesion. Hysterical. Hypnotic. Subjects ; horse, ox, 
wolf, cat, chicken, Gnineapig, snake, frog, crayfish. Causes : strong mental 
impression, Indigestion, etc, in susceptible system. Lesion : inconstant, 
muscular degeneration, etc. Symptoms : wax like retention of position 
given, voluntary movement in abeyance, mental functions impaired, secre- 
tions altered. Duration and frequency variable. Treatment : shock ; cold ; 
ammonia, pepper, snuff, electricity, amyle nitrite, nitro- glycerine, apomor- 
phine, bromides, purgatives, bitters, iron, zinc, silver, open air exercise. 

Definition, This is a functional nervous disorder, characterized 
by paroxysms of impaired or perverted consciousness, diminished 
sensibility, and above all a condition of muscular rigidity, by 
means of which the whole body, or it may be but one or more 
limbs retain any position in which they may be placed. 

Laycock describes two forms in man — the catochus or tetanic 
form, and the paralytic form. Mills would restrict the name cat- 
alepsy to cases in which the muscular tone is such' that the affect- 
ed part may be bent or moulded like wax or a leaden pipe, and 
will not vary from this when left alone. Other forms in which 
this waxen flexibility (flexibilitas cerea) is absent or imperfect 
he would designate as catalepoid. 

The disease is not associated with any constant cerebral lesion, 
though it may supervene in the course of other nervous disorders, 
and therefore may own an exciting cause in existing lesions of 
the brain. The immediate cause must however be held to be 
functional, and this is in keeping with its most common form in 
man (hysterical), and with the hypnotic form which is observed 
both in man and animals. This latter may be looked on as 
a form of induced or hypnotic sleep, in which the retention of the 
position given to a limb or part is the most prominent symptom. 
In all cases there is an impaired condition of the sensory func- 
tions of the cerebral convolutions, and an insusceptibility of the 
motor centres to the control of the will, or the reflex stimulus. 



Catalepsy, 37 

Hering has recorded the disease in the horse, Landel in the ox, 
and Leisering in the prairie wolf. The hjrpnotic form has been 
shown in cats, chickens, and Guinea pigs. The serpent charm- 
ing of the Indian dervishes and similar effects on frogs and cray- 
fish have been attributed to hypnotic catalepsy. 

Causes. Strong mental emotions and diseases which pro- 
foundly affect the nervous system have been adduced as causes 
(fear, excitement, chills). Indigestible food has even been 
charged with causing it. There is undoubtedly, to begin with 
a specially susceptible nervous system, and hence it is liable to 
prove hereditary, and in man to appear as a form of hysteria, or 
to alternate in the same family with epilepsy, chorea, alcoholism, 
opium addiction and other neurosis. 

Hypnotism as a cause is claimed by various writers. Azam 
says that in the fairs in the South of France, jugglers hypnotize 
cocks by placing the bill oh a board, on which they trace a black 
line passing between the two feet of the bird. Cadeac adds that 
Father Kircher, in the 17th century, employed a similar method 
to put fowls to sleep. Alix put cats to sleep by securing them 
firmly, and then looking steadily into their eyes. The condition 
attained varies according to the degree of the sleep, the will being 
dominated first, and later, consciousness of external objects is 
lost. Hypnotism, however, appears to be difficult and uncertain 
in the lower animals, in keeping with the limited development of 
intelligence and will, as compared with the human being. Cadeac 
states that the very old and the very young are completely refrac- 
tory to hypnotizing influences. 

Lesions, No constant pathological changes are found, though 
different nervous lesions may serve to rouse the disease in a pre- 
disposed subject. Frohner found in the affected muscles granu- 
lar swelling, fatty degeneration, haemorrhages, and waxy (amy- 
loid) degeneration of the cardiac muscles, corresponding to what 
has been found in tetanus ; also haemorrhages on the stomach 
and intestines. 

Symptoms, The leading objective symptom is the tonic con- 
dition of the muscles by which a perfect balance is established and 
maintained between the flexors and extensors so that the affected 
part maintains the same position which it had when the attack 
began, or any other position which may be given to it during the 



38 Veterinary Medicine. 

progress of the paroxysm. The position is only changed when 
the muscles involved have become completely exhausted. Dur- 
ing the attack the affected muscles are swollen and firm, so that 
their outline may often be traced through the skin, later as the 
attack subsides they become soft and flaccid. Voluntary move- 
ment of the affected muscles is impossible until after the 
paroxysm. The attack usually comes on suddenly and in this 
respect resembles epilepsy ; at other times there are premonitory 
symptoms of nervous anxiety, excitement or irritability. There 
is usually considerable impairment of consciousness, intelligence, 
common sensation, and even of the special senses. In a cataleptic 
dog Frohner noted mental and motor troubles, considerable 
anaesthesia, and loss of sight, smell, and hearing. The eyes are 
fixed, the pupils either contracted or dilated, and the urine 
passed may be albuminous or even icteric. 

Course, Duration. Like other functional nervous disorders 
this is extremely uncertain in its progress. There may be but 
one attack or a succession ; they may last from a few minutes, 
to 7 days (Frohner), or even several weeks (Hertwig) ; they 
may end in recovery or less frequently they may prove fatal 
usually by inanition. 

Treatment, During a seizure a sudden shock will sometimes 
cut short the attack, douching with cold water, an inhalation of 
ammonia, of capsicum or of snuff, or the application of electricity 
in an interrupted current through the spine and affected muscles. 
Ether anaesthesia will not always relax (Sinkler). Inhalation 
of a few drops of nitrite of amyle has proved effective in man, as 
has also the injection subcutem of three drops of a i per cent, 
solution of nitro-glycerine ; apomorphine hypodermically is 
usually effective (Sinkler). Bromide of potassium has also been 
advised, and in case of coldness of the surface, a warm bath. 

When there is overloaded stomach and gastric indigestion an 
emetic is indicated, and in constipation a purgative (for speedy 
action chloride of barium or physostigma subcutem). 

In the intervals between attacks tonics and general hygiene 
should be invoked to build up the weakened nervous system. 
Quinine, and salts of iron, zinc or silver with a nourishing diet 
and out door exercise are especially indicated. 



INSOLATION. HEAT EXHAUSTION. SUNSTROKE. 
THERMIC FEVER. 

Definition : two forms. Heat exhaustion. Causes : prolonged beat, 
and moisture, overexertion. Impaired vaso- motor centre. Failing heart, 
Carbon dioxide poisoning. Symptoms : weak, fluttering pulse, perspiration, 
muscles flaccid, prostration, no hyperthermia. Treatment : stimulant, digi- 
talis, digitalin, subcutem, nitroglycerine, warm baths. Thermic fever. 
Hyperthermia excessive. Causes : insolation , prolonged heat and impure air, 
furnace heat, moist and dry heat, electric tension, overwork, muscular ex- 
haustion, coagulation of myosin, constant heat on one part (head), excess of 
carbon dioxide, stiffening of bodies when killed in hot weather, debility, 
weakness, fatigue, chest constriction, tight girths or collars, short bearing 
reins, plethora, obesity, open cars and yards, fever, privatiou of water, heavy 
fleece. Lesions : right heart and systemic veins full, blood black fluid or 
diffluent, left ventricle empty, congested meninges, effusions in or on brain, 
or hemorrhages. Symptoms : horse : dull, stupid, stubs toes, sways quar- 
ters, droops head, hangs on bit, props on feet, breathes rapidly, pants, stertor, 
dUated nostrils, gasping, fixed eyes, dilated pupils, tumultuous heartbeats: 
gorged veins, epistaxis, perspiration, convulsions ; ox : parallel symptoms ; 
sheep : open mouth, stertor, fixed eyes, pupils dilated, panting, swaying, 
fall, convulsions ; doff : dull, prostrate, pants, congested veins and mucosae, 
weakness, spasms, syncope, speedy rigor mortis. Overheating. Diagnosis : 
early excessive hyperthermia, venous congestion, shallow panting breathing, 
violent heart action, loss of sensory and motor f unci ions, convulsions. 
Prevention : avoid violent, prolonged heat, and exertion, especially in case 
of fat animals or those new to hot climate, keep emunctories acting, shade 
head, water on head and to drink, protect fat cattle, shear sheep, water. 
Treatment : shade and laxatives ; if severe, cold water from hose, ice bags 
to poll, rub legs, acetanilid subcutem, stimulant enemata, later mineral 
tonics, iron or zinc. 

Definition, A morbid condition produced by the exposure to 
extreme heat, and marked by profound disorder of the vaso- 
motor and heat centres. 

The single term of sun-stroke or heat-stroke has been replaced 
by two, — heat exhaustion and sun-stroke, indicating two dis- 
tinct conditions, brought about by exposure to heat and mani- 
fested by different states of the body and distinctive symptoms. 

Heat Exhaustion. 

This appears as an exaggerated form of the general sense of 
relaxation, weakness and languor which follows on prolonged 
39 



40 Veterinary Medicine, 

violent exertion in a hot atmosphere. There is more or less im- 
pairment of the vaso-motor nerve centre in the medulla, relaxa- 
tion of the capillary system, and flagging of the heart's action, 
which loses its customary stimulus, by reason of the defective 
supply of blood returned by the veins. This may become so ex- 
treme that the patient dies by syncope. In other cases the 
paresis is mainly shown in the vaso-motor system, and its centres 
in the medulla, the blood is delayed in the distended capillaries 
and veins, it becomes overcharged with carbon dioxide, the 
heart's action is accelerated and feeble, the pulse rapid, weak 
and fluttering, perspiration breaks out on the skin, and the tem- 
perature is normal or subnormal. The muscular weakness, the 
flaccid condition of the facial muscles, and general depression 
suggest a state of coUaps^. This condition is not necessarily due 
to exposure to the intensity of the sun's rays, but may come on 
in animals subjected for a length of time to artificial heat, and 
especially if the air is impure, and if the subject has to undergo 
severe physical exertion. 

Treatment. In slight cases of this kind a stimulant is usually 
desired and ammonium carbonate in bolus or solution will 
usually serve a good purpose. In its absence alcohol or spirits 
of nitrous ether may be given. Digitalis is of great value in 
sustaining the flagging action of the heart and has the advantage 
that as digitalin it can be given hypodermically when it is im- 
possible to give ammonia, alcohol or ether by the mouth. For 
the same reason nitro- glycerine may be resorted to, or even 
atropia as a vaso-motor stimulant. Active friction of the body 
and limbs will aid circulation and indirectly stimulate the heart, 
and in case of subnormal temperature it may be supplemented 
by a warm bath in the smaller animals, kept up until the normal 
temperature in the rectum has been restored. 

Thermic Fever. Sun-stroke. 

This is readily distinguished from heat exhaustion by the pre- 
dominance of the hyperthermia. While in heat exhaustion 
the temperature is usually subnormal, in sun-stroke it is exces- 
sive, (108^-113^ F.). 

Causes, The immediate cause of sunstroke is exposure to 
undue heat, but this need not be the heat of the sun's rays direct. 



Insolation. Sun- stroke. Thermic Fever. 41 

A large proportion of cases in the human subject are attacked 
during the night, and again at sea where an attack in a passenger 
is practically unknown, it is terribly common among stokers 
working in a close atmosphere of 100® to 150** F. 

The attendant conditions have much influence in determining 
an attack, thus it is generally held that heat with excess of moist- 
ure is the most injurious, yet in Cincinnati, statistics showed a 
greater number of cases in man when the air was dry. The sup- 
pression of perspiration and the arrest of cooling by evaporation 
in the latter case would tend to a rapid increase of the body tem- 
perature, and the condition would be aggravated by the electric 
tension usually present with the dry air. With the hot, moist air 
perspiration might continue, but evaporation would be hindered, 
and there would be' arrest of the cooling process and an extreme 
relaxation of the system. 

Again, it is usually found that seizures take place during or 
after hard muscular exertion in a hot period, and much importance 
is attached to the attendant exhaustion, the excess of muscular 
waste, and the alteration of the myosin, which latter coagulates 
at a lower temperature in the over-worked animal. But on the 
other hand, experiment shows that the animal confined to abso- 
lute inactivity in the hot sunshine or in a high temperature (at 
90**), dies in a few hours, whereas another animal left at liberty 
in the same temperature does not suffer materially. The explana- 
tion appears to be that the dog, kept absolutely still, iias the contin- 
uous action of the heat on the same parts and on the same blood, 
for the capillaries dilate, and the blood is delayed, overheated, 
and surcharged with carbon dioxide, and the result is either syn- 
cope from heart failure, or asphyxia from excessive carbonization 
of the blood. Back of these and concurring with them is the par- 
alysis of the vaso-motor and heat generating nerve centres, from 
the high temperature or the condition of the blood. 

The excessive carbonization of the blood deserves another word. 
The prolonged contact of the blood and air in the lungs is essen- 
tial to the free interchange of oxygen and carbon dioxide. Vie- 
rordt showed that with sixty respirations per minute the expired 
air became charged with but 2.4 per cent, of this gas, whereas 
with fourteen respirations it contained 4.34 per cent. Therefore, 
with violent muscular work (which charges the blood with carbon 



42 Veterinary Medicine. 

dioxide) and rapid breathing (which fails to secure its elimina- 
tion), the over-driven animal soon perishes from asphyxia. Un- 
der a high temperature of the external air, this condition is aggra- 
vated since the rarified air contains just so much the less oxygen, 
the absorption of which is the measure of the exhalation of car- 
bon dioxide. 

Dr. H. C. Wood, who has experimented largely on the subject 
in animals, finds the cause of heart failure in the coagulation of 
the myosin; which takes place under ordinary circumstances at 
1 15** F. , but at a much lower temperature when a muscle has been 
in great activity immediately before death. As the temperature 
of thermic fever frequently reaches 1 13®, or even higher, he easily 
accounts for the sudden syncope occurring during active work in 
a high temperature. As an example of such sudden rigor, he ad- 
duces the sudden stiffening of the bodies of some soldiers killed 
in battle during hot weather. 

Wood further shows that all the symptoms of thermic fever can 
be produced in the rabbit by concentrating the temperature on its 
head, which seems to imply a direct action on the brain and in par- 
ticular on the heat producing and vaso- motor centres. This becomes 
the more reasonable that the temperature attained does not im- 
pair the vitality of the blood but, leaves the leucocytes possessed 
of their amoeboid motion. He found, moreover, that if the heat 
were withdrawn before it has produced permanent injury to the 
nervous systepi, blood or other tissues, the convulsions and un- 
consciousness are immediately relieved and the animal recovers. 

Other conditions may be adduced as predisposing or concurrent 
causes of thermic fever. Whatever impairs the animal vigor has 
this effect. Fatigue, as already noticed, is a potent factor, in 
man a drinking habit ; in all animals a long persistence of the 
heat during the night as well as the day ; impure air in badly 
ventilated buildings ; and mechanical restriction on the freedom 
of breathing. In military barracks with the daily temperature at 
118** F. and the night temperature 105, the mortality became ex- 
treme, and in close city car stables the proportion of sun-strokes is 
enhanced. In all such cases, the air becomes necessarily more 
and more impure continually. The atmosphere has the same 
heat as the animal body, so that no upward current from the lat- 
ter can be established, to create a diffusion. The carbon dioxide 



Insolatwn, Sun-stroke. Tkermk Fever. 43 

and other emanations from the longs, the exhalations from the 
skin, dung and urine, accumulate in the air immediately sur- 
rounding the animal and respiration becomes increasingly imper- 
fect and difficult. This condition is further aggra\'ated by the 
accumulation of the animal heat in the body. The blood circu- 
lating in the skin can no longer be cooled, to return with refrig- 
erating effect on the interior of the body, the cooling that would 
come from the evaporation of sweat is obviated by the suppres- 
sion of that secretion, as well as by the saturation of the zone of 
air immediately surrounding the body, and thus the tendency is 
to a steady increase of the body temperature until the limit of 
viability has been passed. 

The mechanical restriction of respiration should not be over- 
looked. In European soldiers landed in India and marched in 
the tight woolen clothing and close stocks a high mortality has 
been induced and in horses with tight girths or collars and short 
bearing reins, and oxen working in collars a similar result is ob- 
served. Any condition of fever is a potent predisposing factor. 

Horses or cattle that are put to violent or continued exertion 
when too fat or out of condition are especially subject to sun- 
stroke. Pat cattle driven to market under a hot sun, or shipped 
by rail, crowded in a car and dela3red on a siding under a hot sun, 
with no circulation of air, often have insolation in its most violent 
form. The same may be seen in the hot stockyard, with a still 
atmosphere and the fat animals subjected to the full blaze of a 
July sun. The chafed feet caused by travel, and the muscular 
weariness caused by standing in the moving car are material ad- 
ditions to the danger. 

Similarly horses suffer on the race track when subjected to 
protracted and severe work in hot weather, or again dragging 
loads in a heated street under a vertical sun, or on a side hill, 
with the sun's rays striking perpendicularly to its sifrface. 

A change in latitude has a decided effect, the Northern horse 
suffering much more frequently than the one which is native to 
the Southern States and which has inherited the habit of heat 
endurance. 

Finally faults in feeding and above all watering are appreciable 
factors. The privation of water in particular is to be dreaded. 
Tracy in his experience with American soldiers in Arizona found 



44 Veterinary Medicine. 

that the command could usually be guarded against sun stroke 
when a supply of water was kept on hand. It should be used 
guardedly, but nothing would act better in obviating an attack. 
On the other hand, when the canteens were empty, under the 
hot sun the seizures increased disastrously. 

Sheep are especially liable to sufiFer from heat by reason of 
their dense fleece, which hinders the evaporation of perspira- 
tion, and the cooling effect of air on the skin. When the 
temperature rises, respiration is accelerated and panting, the 
lungs seeking to supplement the work of the skin. When 
traveling in a heavy fleece, or in the hot sunshine in July or 
August sun stroke is not uncommon among them. 

Lesions. Among the lesions ^may be named, vacuity of the 
left ventricle and fullness of the right ventricle and veins with 
fluid blood or a diffluent clot ; Congestion of the pia or dura 
mater, effusion into the ventricles, haemorrhages into the sub- 
serous tissues, and degeneration of the muscles. 

Symptoms, Horse. When premonitory symptoms are ob- 
served the animal fails to respond to whip or voice, lessens his 
pace, stubs with his fore feet and sways with the hind, depresses 
his head and hangs heavily on the bit. 

Too often these are omitted or overlooked, and the horse sud- 
denly stops, props himself on his four limbs, drops and extends 
the head, breathes with great rapidity, -panting and even stertor, 
dilates the nostrils widely, retracts the angle of the mouth and 
even gapes, has the eyes fixed, the pupils dilated and the beats 
of the heart tumultuous. The superficial veins are distended, the 
visible mucosae congested with dark blood, and blood may escape 
from the nose. Perspiration usually sets in. 

The animal may fall and die in a few minutes in convulsions, 
or, if stopped sufficiently early and suitably treated, he may in a 
measure recover in 15 to 20 minutes. 

Symptoms. Ox. The premonitory symptoms are like those 
in the horse : dullness, rapid panting, breathing, the mouth is 
opened and the pendent tongue is covered with frothy saliva, a 
frothy mucus escapes from the nose, the eyes are congested and 
fixed, the pupils dilated, the nostrils and flanks work laboriously, 
the heart palpitates, the animal sways or staggers and falls. 
Death follows in convulsions, or it may be delayed, the animal 



Insolation . Sun-stroke, Thermic Fever. 45 

struggling ineflFectually tp rise, or having periods of comparative 
quiet. The rectal temperature is very high, 107** to 114° F. If 
able to stand, there is usually blindness and heedlessness of sur- 
rounding objects. 

Symptoms. Sheep. The oi^n mouth, protruding tongue, 
frothy saliva, reddened fixed eyes, rapid breathing, beating 
flanks, stertor, and unsteady gait are characteristic when taken 
along with the manifest causes. Swaying movements followed 
by a sudden fall and death in convulsions form the usual termina- 
tion of the disease. 

Symptoms. Dog. These have been mainly produced experi- 
mentally and consisted in hyperthermia, dullness, prostration, 
accelerated breathing and heart action, congested veins, and 
mucosae, muscular weakness, convulsions, and syncope or as- 
phyxia. After death the muscles became speedily rigid, and 
the blood accumulated in the venous system, was fluid or only 
loosely coagulated. In these animals, if the experiment were 
stopped in time the animal could be restored to health. 

Slighter cases may occur in the different animals, more partic- 
ularly from overdriving in hot weather, and in such cases the 
overheated animal recovers, but there is liable to remain a special 
sensitiveness to excessive heat and a tendency to be dull, sluggish 
and short winded, to hang the head in hot weather, and to seek 
shelter from the direct rays of the sun. 

Diagnosis is largely based on the suddeness of the attack, on 
the occurrence of high temperature before the seizure, not after as 
it is liable to be, if at all, in apoplexy, on the dark congestion of 
the mucosae, and of the venous system, on the rapidity .and shal- 
lowness of the respirations, on the tumultous action of the heart, 
and on the general loss of sensory and especially of motor func- 
tion, in circumstances calculated to induce sunstroke. Localized 
paralysis or spasm would suggest the formation of a cerebral ef- 
fusion or clot. 

Prevention. This will depend on the class of animal and its 
conditions of life and work. In horses care should be taken 
to regulate the work by the heat of the season and condition of 
the animal. When the temperature ranges from 80° to 100° F. 
the work should be lessened and every attention should be given 
to maintain the healthy functions (bowels, kidneys, skin) in good 



46 Veterinary Medicine. 

working condition. If the horse is young, fat, or out of condi- 
tion from idleness or accumulation of fat he must have the 
greater consideration. So it is with a horse recently come from a 
colder latitude, and with a heavy draught horse that may be 
called on to do rapid work. Some protection is secured by wear- 
ing a sunshade or wet sponge over the poll, and much may be 
expected from an occasional rest in the shade, a swallow of cool 
water and sponging of the head. 

Very heavy fat cattle should not be driven far nor shipped pn 
the hottest days, and the packed car should not be left in the 
full sunshine in a still atmosphere. Yards with sheds under 
which they can retreat must be secured if possible. 

The heavily fleeced sheep must have equal care and the pastures 
for fat sheep and cattle should have available shade in form of , 
trees, walls or sheds. Access to water is an important condition. 

Treatment. In slight cases {overheated) a few days of rest, 
under an awning rather than in a close stable, with a restricted 
and laxative diet. 

In severe thermic fever the first consideration is to lower tem- 
perature. If available turn a hose on the head, neck and entire 
body for five or ten minutes, or until the rectal temperature ap- 
proaches the normal. In the absence of such a water supply, 
dash cold water from a well on the body but especially the head 
and neck, and if available tie a bag of ice around the poll. Active 
friction to the legs and body is often of great advantage. A large 
dose of antipyrin or acetanilid may be given hypodermically. On 
the other hand stimulants, and especially carbonate of ammonia, 
or sweet spirits of nitre may be given as an enema. This may 
be repeated in an hour in case the pulse fails to acquire force and 
tone. 

Should the temperature rise again later it may often be kept in 
check by cold sponging and scraping followed by rubbing till 
dry. 

In case of continued elevation of temperature, with heat of the 
head, and perversion of sensory or motor functions, meningitis 
may be suspected and appropriate treatment adopted. 

For the prostration and weakness that is liable to follow therm- 
ic fever, mineral tonics such as the salts of iron or zinc may be 
resorted to. 



EPILEPSY. FALLING SICKNESS. 

Definition. Frequency. Susceptibility : dogs, pigs, cattle, horses, par- 
rots, sparrows. Divisions: slight and severe ; Jacksonian (partial) ; sympto- 
matic ; idiopathic. Lesions ; inconsUnt ; of brain, cranium, cerebral circu- 
lation, myelon, poisons in blood, dentition, cortical and ganglionic lesions, 
cerebral asymmetr}-, stenosis of vertebral canal. Medullar asymmetry, 
timnmas of cranium, aneemia, bleeding, carotid ligation, spinal reflexes, 
irritation of the skin, creatioin, dncbonoidin, lead, ergot, nitropentan, 
nitro-benzol. ptomaines, toxins, parasites, nerve lesions, local hyperae^thesia 
(withers of horse, recurrent ophthalmia), indigestion, constipation, sciatic 
neuritis. Causes : nervous predisposition, heredity (man, cat, dog, ox), 
sexual excitement, fear, sudden strong, visual impression, uric acid in 
blood, meat diet Symptoms: hone, sudden seizure, bracing feet and 
limbs, swa}ing, fall, convulsive rigidity, jaws working or clenched, eyes 
rolling, salivation, stertor, dyspnoea, sensation absent. Duration. Symp- 
toms of localized epilepsy. Cattle, bellow, stertor, rolling eyes, jerking 
rigidity, fall. Sheep. Swine. Premonitory malaise, jerking, champing 
jaws, fall, trembling, rigidity, involuntary discharges. Doff : trembles, 
cries, falls, rigidity, clonic contractions, stertor, sequelae. Diagnosis: 
fudden attack, unconsciousness, spasms, quick recovery, no spasms in 
cyncope, vertigo has no spasms, thrombosis has symptoms developed by ex- 
ercise. Jurisprudence : animal returnable after twenty-eight days ( Wurten- 
berg, etc.), thirty days (Prance). Treatment : of susceptible brain, and 
peripheral irritant. Correct all irritation or disease, or expel parasites. 
Nerve sedations : bromides, opium, valerian, belladonna, hyosdne, duboi- 
sine. Tonics : rinc, arsenic, silver, baths, electricity. Borax. Vegetable 
diet. Castration. Avoidance of excitement. Surgical operations. Tre- 
phining. Excision of cortex. Outdoor life. During a fit : amyle nitrite, 
chloroform, ether, chloral, warm hath, cold or warmth to head, quiet se- 
cluded place. 

Epilepsy is the name given to a class of cases characterized by 
a sudden and transient loss of consciousness with a convulsive 
seizure, partial or general. It appears to be due to a sudden ex- 
plosive discharge of convulsive nervous energy, which may be 
generated by a great number of catises of morbid irritation — 
pathological, traumatic, or toxic. As a rule the epileptic seizure 
is but the symptomatic expression of a complex derangement 
which may be extremely varied as to its nature and origin. 

Frequency in different animals. The affection is far less fre- 
quent in the domestic animals than in man, doubtless becatLse of 
47 



48 Veterinary Medicine, 

the absence of the special susceptibility which attends on the 
more highly specialized brain, the disturbing conditions of civ- 
ilization, and the attendant vices. 

Among domestic animals, dogs are the most frequent victims 
in keeping with their relatively large cerebral development, their 
emotional and impressionable nature and the unnatural and arti- 
ficial conditions in which as house pets they are often kept. 
Their animal food and the consequent uric acid diathesis is a 
probable cause, as it is in man. In ten years of the dog clinic at 
Alfort they made an average of 3 per cent, of all cases. Next to 
the dog the pig kept in confinement is the most frequent victim, 
while cattle and horses come last. At the Alfort clinic epileptic 
horses were not more than i per 1000 patients. It is not at all 
unfrequent in birds, especially canaries and parrots. Reynal 
has seen it in sparrows. 

Divisions. The disease has long been divided into petit mal 
^nA grand mat (hautmai). The petit mal (slight attack) is 
usually a transient seizure affecting a group of muscles only and 
associated with only a momentary or very transient loss of con- 
sciousness. The loss of consciousness is uncertain in many 
cases. Under partial epilepsies must be included the hemi- 
epilepsy, or Jacksonian epilepsy, which is confined to one side of 
the body. 

The grand mal (severe attack) is one in which the loss of 
consciousness is complete, and the convulsions are general in the 
muscles of animal life. 

Another division is into symptomatic and idiopathic cases, 
and if this distinction could always be made it would be of im- 
mense value in the matters of prognosis and treatment as the re- 
moval of the morbid state of which epilepsy is the symptom will 
usually restore the patient to health. Thus the removal of 
worms from the alimentary canal, of indigestible matters from 
the stomach, of a depressed bone or tumor from the surface of 
the brain may in diflFerent cases be the essential condition of a 
successful treatment. 

Morbid Anatomy and Pathology. The literature of epilepsy is 
very rich and extensive and yet no constant lesions of the ner- 
vous system can be fixed on as the local cause of the disease. A 
review of the whole literature leads rather to the conclusion that 



Epilepsy, Falling Sickness, 49 

irritations coming from lesions of the most varied kind, acting on 
a specially susceptible brain wiU rouse the cerebral centres to an 
epileptic explosion. Thus epilepsy has been found to be asso- 
ciated with lesions of the following kinds : 

ist. Brain lesions of almost every kind, including malformations. 

2nd. Lesions of the walls of the cranium. 

3d. Disorders of the cerebral circulation. 

4th. Lesions of the spinal cord. 

5th. Morbid states of the circulating blood (excess of urea, 
uric add, creatinin, lead poisoning.) 

6th. Reflected irritation, as from dentition, worms, sexual ex- 
cesses, injuries to certain nerves, notably the sciatic, or to par- 
ticular parts of the skin. 

ist. Brain lesions. Those which affect the medulla and the 
cortical convolutions around the fissure of Rolando would be ex- 
pected to be implicated because these centres preside over the 
principal motor actions of the body and limte. Yet though 
these parts are found to be affected with various morbid lesions 
in a certain number of cases of epilepsy, such lesions are ex- 
ceptional, rather than the rule. In 20 cases of epilepsy in man, 
15 showed no lesion whatever of the brain. Blocq and Marinesco, 
pupils of Charcot, recently made a critical examination of the 
medulla and Rolandic cortex in nine cases that died during the 
fit. All showed granular bodies (degenerated myelin or blood 
pigment) in the perivascular sheaths but they found these in dis- 
seminated sclerosis and even in healthy brains as well. The neuro- 
glia cells of the first cortical layer contained black granules. 
Otherwise four cases had no change, while five showed sclerosis of 
the cortex. The medulla was sound in aU cases excepting one 
which showed punctiform haemorrhages. Visible lesions may be 
present in other parts of the brain ; Wenzel long ago claimed 
constant lesion of the pituitary body. Beside the cerebral cortex, 
lesions have been found in the bulb, the h3rpoglossal nucleus, 
the olivary body, the hippocampi, the thalamus, the corpus 
striatum, the quadrigemini, the cerebellum, etc. Hughlings- 
Jackson who made an extended investigation of the subject con- 
cludes that any part of the gray matter of the encephalon may 
become over-exdtable and give rise to a convulsive attack. Not 
4 



50 Veterinary Medicine, 

only may the lesion be in any part of the brain, but it may be of 
any kind : meningitis, cerebritis, softening, tubercle, tumor, hy- 
datid, embolism, or dropsy. Marie Bra found an extreme asym- 
metrj' of the cerebral lobes in epileptics. Kussmaul and others 
found stenosis of the vertebral canal and asymmetry of the two 
lateral halves of the medulla. 

2nd. Cranial lesions. These consist largely in blows or 
falls upon the head, with ostitis, periostitis, fractures with de- 
pressions, fibrous neoplasia implicating or not the meninges and 
pressing on the brain, haemorrhages from minute arteries, etc. 
The diagnosis of such lesions will often open a way to a success- 
ful treatment. Baker found most of the severe cases from head 
injuries. 

3d. Disorders of the cerebral circulation. Burrows, 
Kussmaul and Turner showed that in animals, loss of conscious- 
ness and epileptiform convulsions followed on cerebral anaemia 
caused by profuse bleeding or by compression of the carotids. 
The same has been observed in surgical cases after ligation of 
one common carotid. Hermann caused convulsions in a rabbit 
by ligating both anterior and posterior venae cavae. 

4th. Lesions of the Spinal Cord. Brown-Sequard determined 
epileptiform convulsions by transverse section of one half of the 
spinal cord, or of its superior, lateral or inferior columns. The 
later development of the doctrine of interrupted spinal inhibition, 
suggests that, many of the seizures in question are but exaggera- 
ted spinal reflexes, which are no longer restrained by cerebral in- 
hibition. That all are not of this spurious kind may be fairly 
inferred from his further demonstration that bruising of the great 
sciatic in animals tended to produce epilepsy. In such cases the 
irritation of certain areas by pinching the skin, served to produce 
a seizure. Not only so, but the animals in which such artificial 
epilepsy had been induced tended to transmit the infirmity to 
their progeny. The prevailing view of epilepsy however, would 
consider such lesions as sources of peripheral irritation by which 
the brain is affected sympathetically, while the real explosion is 
the result of the sudden discharge of the pent up excitement 
caused in the encephalic centres by the irritation at such distant 
points. 



Epilepsy, Falling Sickness. 51 

5th. Morbid States of the Circulating Blood. Certain 
poisons, when brought in contact with encephalic nerve centres 
produce epileptic seizures. Gallerani and Lussana applied 
creatinin directly to the cerebral cortex and quickly induced 
epileptiform convulsions and choreiform movements. Injected 
subcutaneously it failed to produce the same effect. Cinchonoidin 
acted on the basal ganglia of the brain producing convulsions 
but no choreiform movement. Poisoning with lead, ergot, nitro- 
pentan, nitro-benzol and a number of other poisons brings about 
intermittent convulsive seizures. The same may be inferred of 
ptomaines and toxins, in the convulsions that appear in the ad- 
vanced stages of infectious diseases (canine distemper, hog 
cholera, etc.). 

6th. Reflex Irritation. Perhaps no peripheral irritation 
more frequently causes epilepsy, than parasites. In young dogs 
worms in the intestines (taenia coenurus, taenia tenuicoUis, taenia 
serrata, taenia echinococcus, and ascarides) have been especially 
incriminated. Also linguatula taenioides in the nasal sinuses. In 
young pigs the echinorrhynchus gigas, ascarides and trichocepha- 
lus. In horses ascarides have been principally blamed. 

Wounds implicating nerves, and tumors pressing on nerves, 
have served as sources of nervous excitement which accumulates 
in the cerebral ganglia and bursts forth as an epileptic explosion. 
Bourgelat mentions the case of a horse which fell in a fit the 
moment he was touched on his tender withers, also a case in 
which a seizure coincided with an attack of recurrent ophthalmia. 
Gerlach saw a horse which had an epileptic fit the instant he was 
touched on his sensitive withers. In kittens and puppies the 
irritation attendant on dentition is a common cause of attacks. In 
nervous dogs and pigs indigestion or constipation may serve as 
the occasion of an explosion. In the experimental cases of 
Brown-Sequard, not only did the injury to the sciatic nerve de- 
velop in the brain a latent tendency to epilepsy, but the subse- 
quent pinching of the skin in certain areas (epileptigenous zones) 
promptly brought about a seizure. 

Causes. Most of the causes of epilepsy have been given 
above under the head of pathology and morbid anatomy. The 
nervous predisposition may, like any other peculiarity or function, 
become hereditary. In the human race nothing is more certain 



52 Veterinary Medicine, 

than the tendency to some form of nervous disorder (insanity, 
dementia, alcoholism, morphinism, epilepsy, chorea, etc.) in a 
special family line. Reynal records the case of an epileptic cat 
(belonging to an employe of the Alfort veterinary school) the 
progeny of which for three generations, became affected with 
epilepsy and mostly died before they were a year old. Also four 
epileptic dogs (3 males and i female) which produced a num- 
ber of epileptic puppies. LaNotte records the cases of two bulls 
affected with epilepsy, in the progeny of which numerous cases of 
epilepsy appeared ; the cows being attacked after the first calving, 
and the oxen soon after they were first put to work. Breeding 
stallions are particularly liable to attacks, the high feeding, lack 
of muscular work in the open air, and above all the oft repeated 
nervous excitement attendant on copulation being directly ex- 
citing causes. The heredity of the artificial epilepsy induced by 
Brown-Sequard in Guinea pigs, serves to strengthen the doctrine 
of heredity in ordinary forms. 

Among emotional causes fear easily heads the list. Bernard 
states that a horse became epileptic in connection with the terror 
caused by the giving way of a wooden bridge over which he was 
passing. Bourgelat and Reynal adduce instances, in cavalry 
horses when first put under fire. Reynal records the case of an- 
other which had his first attack when facing a moving locomo- 
tive, and which never again could see an engine in motion 
without suffering another attack. La Notte mentions the case of 
a horse attacked when frightened by a sky rocket ; Romer, the 
case of a horse scared by the sudden display of a white sheet in 
front of him, and Friedberger and Frohner relate cases of attacks 
caused by intense rays of light, as in racing toward the declining 
sun, or the dazzling reflection from the surface of the water. 
Liedesdorf saw it in a dog scared by a locomotive. 

A strong impression like that caused by transition from bright 
light into darkness, by seeing shadows of trees crossing the road, 
or violent suffering caused by severe forms of constraint have 
been named as causes. 

Speaking in ** Brain,** of epilepsy in man, Alexander Haig at- 
tributes the fits to the fluctuations of uric acid in the blood. 
Headache (migraine) he finds to be very closely allied to epi- 
lepsy and convulsions and to be a result in a susceptible system 



EpiUspy, Falling Sickness. 53 

of a liberal flesh diet. By a vegetable and fruit diet he reduces 
the ingestion and formation of uric acid, so that the largest 
quantity which a patient is likely to get into his blood, shall 
never or only very rarely, affect the blood pressure and increase 
the intra-cranial circulation to a dangerous extent. In predis- 
posed subjects, all flesh food, soup, and meat extracts must be 
avoided, while even tea, coffee, cocoa and other vegetable arti- 
cles containing zanthin compounds are to be regarded as pro- 
ducing uric acid, and to be denied, or employed only as the 
merest flavoring. 

This position is greatly strengthened by the fact that epilepsy 
is so much more frequent in the camivora (dog, cat, bird) than 
in the herbivora. It also suggests very strongly a light vege- 
table diet for both prophylactic and curative purposes in our 
domestic animals. In the same line the frequent and liberal 
drinking of warm water, the use of diuretics and the flushing of 
the large intestine are indicated. 

For other causes see under pathology. 

Symptoms in the Horse. It has been claimed that premoni- 
tory symptoms, such as dullness, lack of energy and quick, ner- 
vous or startled movements herald an attack, but in animals as 
in man, the disease usually attacks suddenly without any ante- 
cedent indication. 

If at work the horse stops suddenly, or if in the stable he 
ceases eating, seems frightened, stands for an instant immovable, 
braces his feet, sways, trembles, and falls heavily to the ground. 
Or he may remain for an instant supported on his rigid limbs, 
the jaws moving or firmly closed, the eyes rolling, and the facial 
muscles drawn or twitching. When down there are convulsive 
movements of the limbs, so that the animal may kick out violent- 
ly, and tense contractions or twitchings may occur in the muscles 
of the croup, chest and abdomen. There is usually an increase 
of the salivary secretion with frothy accumulation about the 
angles of the mouth. The respiration is stertorous, dyspnoeic, 
and interrupted, the nostrils widely dilated, the nasal mucosa of 
a dark brownish red, and the superficial veins distended. The 
pulse is weak, slow, irregular, intermittent and sometimes im- 
perceptible. Sensation seems to be in abeyance. No attention 



54 Veterinary Medicine, 

is paid to loud sounds, nor to pinching, pricking, or even cauter- 
izing the skin. Perspirations may break out on the flank or 
over the whole surface of the body. 

The duration of the attack may be from one to four minutes, 
or exceptionally ten or fifteen, after which the muscles relax, the 
twitching ceases, the horse raises his head, extends his fore 
limbs and finally rises. 

After rising some are dull and stupid for an hour or so, and 
may continue to perspire, some move the limbs, jaws or head 
automatically, turn in a circle, or seek seclusion and darkness, 
while some take at once to eating and seem as if nothing had 
happened. 

In partial or localized epilepsy the spasms are confined to a 
limited groupof muscles like those of the jaws, neck, or fore limbs. 
These may alternately contract and relax, or they may remain rigid 
for a minute or less, the mouth being held open or firmly closed 
with grinding of the teeth, the eyes rolled backward and upward, 
or affected with strabismus, the face drawn and distorted, the 
head turned to one side or downward, or the limbs fixed and 
immovable. 

At the conclusion of an attack it is not uncommon to see a dis- 
charge of urine or faeces, or in stallions, of semen. 

The horse often contracts a fear of the place where the attack 
occurred, and this contributes, with the re-appearance of the 
former object of dread (car, locomotive, rifles, cannon, etc.) to 
precipitate a new attack if he is compelled to go to such a place. 

Symptoms in Cattle. In cattle the animal is attacked without 
premonition, bellows, breathes hard and with effort, has dilata- 
tion of the nostrils, and squinting or rolling upward and back- 
ward of the eyes and falls to the ground rigid and trembling. 
There may be violent succussions of the limbs, head or neck, 
movements of the jaws, grinding of the teeth, and the appearance 
of frothy saliva and elements of food about the lips. The beats 
of the heart are violent, the pulse slow and small, and sometimes 
intermittent. Involuntary micturition, defecation, or discharge 
of semen may occur. In slight cases one or more of these symp- 
toms may be absent, and the victim may not even fall to the 
ground but support himself against a wall or other object. 



Epilepsy, Falling Sickness, 55 

The duration of the attack may be from one to five minutes, 
rarely more, and there is often a slow and progressive subsidence 
of the spasms. When recovered the animal may get up and go 
to eating or rumination as in health. 

Symptoms in Sheep. In sheep the attack is sudden. The 
animal ceases eating or stops in its walking, and after turning or 
other voluntary movement falls to the ground, head extended, 
mouth open, eyes rolling or squinting, and with rigidity or 
twitching of the muscles of the neck or limbs. There is the 
same loss of sensation, frothing from the mouth, and grinding of 
the teeth as in the larger animals. The attack may last 40 to 50 
seconds. 

Symptoms in Swine. In pigs a state of discomfort and rest- 
lessness often marks the approach of an attack, referable probably 
to the digestive disturbance or to parasites which furnish the oc- 
casion of the disease. Uneasy, wandering movements, jerkings 
of head or limbs, rolling of the eyes, champing of the jaws 
may first appear. Then the animal falls, extending its limbs 
and head, with open mouth, retracted lips, and a free flow of 
saliva. Trembling and jerking of the head, neck and limbs, 
hurried, short, difficult breathing, and complete loss of sensation 
may be noted. Discharges of urine, semen, and prostatic fluid 
are not uncommon. The attack usually lasts 2 or 3 minutes, 
and exceptionally 10 to 15. In the shorter seizures, frequent 
repetition is not uncommon, Delafond having observed 5 or 6 
attacks in the course of an hour. 

Symptoms in Dogs. The attack is sudden and unheralded by 
prodromata. The animal stops, trembles, cries plaintively and 
falls ; he may manage to rise or to do so in part but instantly falls 
anew. The limbs stiffen, tremble or twitch, the head is extended 
or flexed, or jerked, violently striking the ground, the mouth 
open, with abundant saliva, or firmly closed though the tongue 
may be between the teeth. The trunk may be firm and rigid or 
alternately twisted in one direction or the other. The eyes roll 
or squint, and the breathing is stertorous and difficult. Insensi- 
bility is complete. Toward the end of the attack there may be 
a discharge of urine, faeces or semen, the stools often containing 
worms. The body is often wet with perspiration during or after 
an attack. 



56 ' Veterinary Medicine. 

The attack usually lasts for two or three minutes, then the 
convulsions gradually lessen in intensity and finally cease, the 
dog raises his head, opens his eyes, and gazes inquiringly around. 
Then he gets on his feet, shakes himself and may at once resume 
his customary habits. In other cases the restoration is less sud- 
den. The dog remains for 30 to 60 minutes dull and stupid, or 
seems to have little power of control over its muscles and stag- 
gers as if intoxicated, or as if the muscles were benumbed. It 
may drop on its knees and thien fall with the head on the ground 
and repeat this several times. In other cases the dog wanders 
around, or trots off and may snap at any one interfering with 
him, so that the case is often mistaken for one of rabies. Finally 
the animal may remain prostrate and fall into a deep sleep marked 
by stertorous breathing. 

Diagnosis, The diagnosis of epilepsy is usually easy. The 
suddenness of the attack, the loss of consciousness, the muscular 
spasms, the complete temporary recovery and the tendency to 
recur, forma toute ensemble, which is pathognomonic. The danger 
of confounding this with other nervous disorders is on the whole 
greatest in the slight cases in which the symptoms are less tjrpical. 

From Syncope it is easily distinguished by the spasms which 
are not present in syncope. 

From eclampsia it is not so easy to diagnose, but the line be- 
tween eclampsia and epilepsy has not been accurately drawn, 
and some have even shown a disposition to drop eclampsia from 
medical nomenclature. Eclampsia may be defined as general 
convulsions dependent on some eccentric irritation, and which do 
not recur after such irritation has been removed. This would 
remove from the category of epileptic attacks the cases of convul- 
sions in which the attacks were due to intestinal or nasal parasites, 
dentition, irritation, tumors pressing oft nerves, canine distemper 
and other infectious diseases. So far the distinction might be 
made by the diagnosis of the particular disease on which the 
convulsions depend. There remains however a class of cases in 
which the centric nervous disorder on which the epileptic seizure 
depends is present, and also the peripheral source of irritation 
(worms, etc.). In such a case the presence of the worms or 
other eccentric source of irritation, even if added to the fact that 
this was the immediate exciting cause of the epileptic explosion. 



Epilepsy, Falling Sickness, 57 

could not do away with the fact that the essential conditions of 
epilepsy are permanently present in the nervous centres. The 
difficulty therefore of making an accurate differential diagnosis, 
resides largely in the impossibility of drawing a definite line of 
pathological separation between eclampsia and epilepsy. 

From Vertigo epilepsy is distinguished by the absence in the 
former of marked spasmodic contractions. It is only in the mild- 
er forms of epilepsy those in which the spasmodic action is so 
slight as to be overlooked, that this disease can be confounded 
with vertigo. 

From Thrombosis or embolism of the iliac or femoral arteries 
epilepsy is easily distinguished by the absence of exercise as the 
essential cause in the development of the latter. In thrombosis 
on the other hand, the loss of control over the hind limbs is de- 
veloped at will by active motion (walking, trotting). In throm- 
bosis too the absence of pulsation at the fetlocks or at any point 
below the seat of obstruction is conclusive. 

Question of Soundness and Jurisprudence. Manifestly a 
horse or bull subject to attacks of epilepsy is not sound. It is 
moreover a disease, the symptoms of which are only shown for a 
very short period at one time, after a long interval of apparently 
perfect health. It is, therefore, a disease against which a purchas- 
er cannot be expected to protect himself and he should have the 
right to annul the sale and return the animal in case the infirmity 
should appear within a reasonable period after purchase. This 
is provided for in the laws of different countries of Europe, thus 
in Wurtenberg, Baden and Hesse, a purchased animal may 
be returned within 28 days ; in France within 30 days, and in 
Bavaria within 40 days. The greatest difficulty arises from the 
frequent impossibility of obtaining expert testimony on a seizure 
which is likely to occur at any moment, without premonition, 
and in which the testimony of a non-expert may easily be mis- 
leading. It seems as if complaint having been made within the 
specified legal time, an extension of guarantee should be given 
by the court, the animal to be meanwhile kept under the super- 
vision of a veterinarian. 

Another question has arisen as to the position of an animal 
suffering from reflex epilepsy. If the attacks are caused by in- 
testinal worms or nasal acarina which are easily removed, it is 



58 Veterinary Medicine. 

quite evident that this cannot be considered as a permanent un- 
soundness, and one for which a contract of sale can be justly 
annulled. But on the other hand, while the eccentric source of 
irritation which is easily curable may have been the active agent 
in developing the seizures, it may be none the less true that the 
central infirmity which determines the abnormal susceptibility, to 
excessive generation and epileptic explosion of nervous force, 
may also be present and the animal cannot be considered as 
sound until a sufficient length of time has elapsed after the re- 
moval of the peripheral irritation and no new seizure has taken 
place. 

Treatment of Symptomatic Epilepsy. In cases due to an ec- 
centric irritant the first step must be the removal of such irritant. 
In case of intestinal worms the various vermicides and tseniacides 
must be resorted to. (See Intestinal Parasites). For the 
linguatula taenioides the injection of benzine or tobacco water 
into the nose, or into the sinuses, with or without trephining may 
be resorted to. In diseased teeth extraction or filling may be 
demanded. In dentition-irritation, lancing of the gums. In all 
other cases in which a peripheral nervous irritation can be traced 
every available means should be taken to remove it. 

Treatment of Central Epilepsy. Bearing in mind that peri- 
pheral irritation is a frequent exciting cause of a seizure, too 
much care cannot be given to the conservation of the general 
health and especially to make the diet wholesome in quantity, 
quality and time of feeding and yiratering, and to guard against 
constipation and indigestion. In dogs a too stimulating meat 
diet is to be avoided. 

The medicinal agents employed have been mainly such as are 
sedative, or tonic to the ner\'ous system. Valerian was long ex- 
tolled as a valuable remedy (Gohier, Delafond, Delwart), and 
this has been improved upon more lately by substituting valerian- 
ate of zinc. Belladonna and its alkaloid atropia have been 
strongl3' advocated (Tisserant, Bernard, Williams, Friedberger) 
and it has the recommendation that it causes vaso-motor contrac- 
tion and tends to lessen cerebral congestion. Hyoscine or du- 
boisine may be used as a substitute. Cyanide of iron has been 
lauded by Jourdier and Tabourin, as far superior to valerian. Of 
late years the nerve tonics, zinc compounds (oxide, sulphate. 



Epilepsy, Failing Sickness, 59 

chloride) and silver salts (nitrate) and arsenic have been used, 
often with excellent results. Borax strongly recommended for 
man ( i to i J^ drachm daily) by Pastena is worthy of a trial for 
dogs. It is given largely diluted in syrup to avoid gastric irri- 
tation. 

Of all agents employed up to the present the bromides still 
claim a foremost place. They should be given in a large dose, 
on an empty stomach and at such a time as to occupy the system 
at the hour when the seizure is exp^ted to recur. Thus for 
morning attacks the dose may be given at night, while for night 
attacks it may be given in the afternoon. Miiller uses sodium 
bromide in the dog as least liable to disturb the stomach, while 
Peterson for man, advnses the potassium salt for the same reason. 
For man, McLane Hamilton advocates a combination of the 
sodium and ammonium salts, Eulenberg adds the potassium com- 
pound, while Berkley uses strontium bromide, and Boumeville 
camphor monobromide. 

Given at night in full dose (30 grs. for dog) the bromides tend 
to secure a quiet sleep, with brain rest and recuperation. If 
beneficial they should be repeated daily until a cure or other sign 
of bromism appears. This may be somewhat checked by arsenic 
or chloral hydrate. 

Wesley Mills finds potassium iodide useful in some dogs when 
bromides fail. Bromohydrate is advocated by Miiller. 
Plechsig and others have had excellent results in man from the 
opium bromide treatment. Pull doses of opium given three 
times a day for six weeks, when they are replaced by full doses 
of bromides four times a day. 

Improvement should be shown in the shortening of the con- 
vulsions and the lengthening of the intervals between them. 
Should the bromides fail in this, resort may be had to other treat- 
ment. 

Toulouse, Clark and others find that privation of salt, in man, 
allows the bromine salt to replace the chlorine one in the tissues, 
and the hydrobromic acid the hydrochloric in the gastric juice, 
and in this way the bromine can be introduced safely in larger 
amount into the tissues and is longer retained, though given in 
half the do$es. 



6o Veterinary Medicine, 

A most important element in the treatment is a vegetable diet 
with or without milk, to obviate excessive production of uric acid. 
Anything which will disagree and produce gastric or intestinal 
fermentations with toxins must be carefully guarded against and 
these will differ in different individuals. 

Stallions and other excitable males, and females may often be 
cured by castration. Patients should be very carefully guarded 
against all sources or excitement, reports of guns, sight of loco- 
motives or automobiles, waving flags, instrumental music, 
sudden exposure to sunshine or other bright light, reflection 
from water, snow, or ice, the contrast of dark shadows, as of 
trees, alternating with bright light, etc. Dogs, becoming ex- 
cited at a show, may have a convulsion if not removed, and 
much more so in presence of another dog in a fit. 

A surgical operation often places the disease in abeyance for 
many months, but, unless in the case of the removal of a dis- 
eased organ which has acted as a factor, this is not permanent. 
Hence in man transient benefit has been secured from operations 
on the eyes, the brain, the testicles, the ovaries, etc. In local 
(Jacksonian) epilepsy, which can be traced to a definite cortical 
area in the brain, the trephining of the skull and the excision of 
the cortex at that point, has given temporary relief, with a local 
palsy, but too often the irritation from the resulting cicatrix has 
in time aroused the disorder anew. Even independently of the 
removal of the cortex, the trephining has been successfully re- 
sorted to, by savage as well as civilized peoples, securing a tem- 
porary relief. Though not in practice in veterinary medicine it 
seems as if this were even more applicable than in man. It 
would be fully justified if it preserved for a year or more an 
animal in usefulness which must otherwise be destroyed, even if 
the disease should return at the end of this time. 

Plunge or douche baths (60° to 70° F.) and rubbing dry will 
often tone up the nervous system, and a course of bitters, or iron, 
or both, may prove valuable. An out-door life and moderate 
muscular exercise are important. 

During a convulsion the animal should be freed from all 
harness, halters, girths, etc., that would impair respiration, the 
jaws must be kept apart with a cloth to prevent biting the tongue, 
and the animal held with head and neck in natural position. 



Eclampsia, Convulsions, Spasms, 6i 

To arrest the spasms the best agent is amyle nitrite inhaled from 
a handkerchief. It may be replaced by a mixture in equal parts 
of chloroform and ether. Or rectal injections may be given 
of chloral. Nitro-glycerine will sometimes cut short an attack or 
prevent it. Small animals may have the body immersed in a 
warm bath, and cold applied to the head. Congested buccal and 
conjunctival mucosae would indicate cold to the head, while 
pallor would suggest warm fomentations. 

When the fit is over the animal should be kept in a quiet, 
dark place until the excitement or stupor has completely passed. 



\ 



t. 



; ECLAMPSIA. CONVULSIONS. SPASMS. 

Definition : functional convulsions from peripheral irritation. Prom den- 
tition, helminths, uterine disease, nursing (anaemia). Treatment.. Injuries 
to cranial bone. 

Eclampsia (convulsions) is difficult to define as distinct from 
epilepsy, the present tendency however appears to be to apply 
this term to cases in which the spasms are of a purely 
functional nature as far as the brain is concerned and 
caused by peripheral nervous irritation. Whereas in epilepsy 
there is some organic disease or disorder of the brain itself. 
Therefore the convulsions of anaemia, of teething, and of 
parasitism, would come under this heading being curable by 
the removal of the distant source of irritation, while the spas- 
modic seizures, that are due to central nervous lesions and are 
not exclusively dependent on peripheral irritation would be 
classed as epilepsy. In other words reflex epilepsies with no 
central brain disorganization would be classed as convulsions. 

Eclampsia from Dentition is seen especially in young cats, 
dogs and pigs when cutting-teeth, and may be obviated by 
lancing the gums, extracting diseased or milk teeth entangled on 
the crowns of their successors, and by a slight laxative with 
bromides. 

Eclampsia from Helminthiasis has been already referred to 
under epilepsy. The main object is the expulsion of the worms, 
after which nerve sedatives and tonics will be valuable. 



62 Veterinary Medicine. 

Eclampsia from Uterine Disease has been noticed by Al- 
brecht, in cows shortly after calving, the symptoms being spasms 
of the neck, persistent extension or turning of the head, grind- 
ing of the teeth, loss of consciousness, convulsive movements of 
the legs, rolling of the eyes, and slow recovery. The same 
symptoms have been observed in goats and have been sup- 
posed to depend on a reflex from the irritated womb. Another 
supposable cause is the absorption of toxic products from the 
womb and vagina. Manifestly the removal of the after birth 
and the disinfection of the womb, should be here employed 
along with the ordinary nerve sedatives. 

Eclampsia in Nursing Female Dogs has long been attributed 
to anaemia by English veterinarians. It occurs especially in high 
bred bitches, when nursing a large litter and some weeks after 
parturition when the puppies have grown large and vigorous, 
with proportionately increased demands on the maternal source of 
supply. The dam shows an emaciated aspect, with restless anx- 
ious eyes, a wearied expression, and a generally exhausted ap- 
pearance. There is weakness and swaying behind, or complete 
inability to use the limbs, the animal goes down, trembles vio- 
lently and shows clonic spasms of the extensors of the legs, the 
neck, the back, the face and the eye. Breathing is accelerated, 
stertorous and labored, the heart beats violently,the mucous mem- 
branes are congested, and the mouth is opened with convulsive 
movements of the jaws and throat. The attack is readily dis- 
tinguished from epilepsy, by the retention of sensation, and by 
the absence of involuntary passages from the bowels, or kidneys. 
Recovery is likely to be secured if the puppies or most of them 
are removed early enough and the bitch sustained by nourishing 
food, and tonics. The spasms may be combated by the anti- 
spasmodics and nerve sedatives employed in epilepsy. Chloroform, 
morphia, phenacetin, acetanilid, urethane have been especially 
commended. Beef teas, cod-liver oil, and iron may be resorted 
to and free outdoor exercise and sunshine should be secured. 

General convulsions are common in connection with direct in- 
jury to the brain and more particularly of its coverings, (cranial 
bones, meninges). In such cases the irritation which otherwise 
starts at a distance and reaches the brain through the afferent 
nerves, or the modification of the circulation acts directly on the 



Chorea, St. Vitus Dance. 63 

gray matter. It is interesting to note in this connection that the 
evacuation of the cerebral fluid, which removes the soft support 
of the water cushion and allows the brain to come in contact with 
the hard bony walls, determines an access of convulsions. In 
cases of convulsions attendant or mechanical injury to the cra- 
nium surgical interference will be in order. 



CHOREA. ST. VITUS DANCE. 

Definition. Snsceptible animal. Canaea: nervona leiaons inconatant, 
youth, debility, anaemia, microbian toxins, cerebral embolism, rhenmatiam, 
trophic alterations in nerve cells, fright. Lesions : variable in seat and 
character, congestion of perforated space, corpns striatum, Sylvian convolu- 
tions, gray matter at root of posterior horn of spinal cord, etc.. ezperi- 
menta of Chanveau and Wood. Symptoms : dog, local twitching, fore limb, 
one or both, neck, head, maxilla, eyelida, eyeballs, hind limbs, trunk, 
rhythmic, less when recumbent, usually absent in sleep, roused by excite- 
ment ; horse, head, neck, fore limb, trunk : cattle, head, neck, limbs ; 
«wine, hind limbs, neck, head ; severe caaea lead to exhaustion, emaciation, 
marasmus, paralysis. Duration : weeks, months, years. Treatment : laxa- 
tive, tonic, hygienic, arsenic, zinc sulphate, strychnia, sedative, belladonna, 
conium, cannabia Indica, chloral, acetanilid, trional, etc., icebags or ether 
•pray to spine, cold douches, outdoor life. 

Definition. A neurosis characterized by constant twitching of 
muscles or of groups of muscles, and which usually ceases during 
sleep. 

Animals Susceptible, This disease is especially common in the 
dog, but has been recognized also in the horse, ox, cat and pig. 

Causes, Much diflFerence of opinion exists as to the true cause 
of chorea. In many cases no nervous lesion has been found and 
therefore the disease has been pronounced purely functional. 
The victims are as a rule the young, weak and debilitated so that 
anaemia has been held to be the main causative factor. Then in 
dogs the affection is a common sequel of distemper and hence it 
has been attributed to toxic matters (microbian, etc. ) in the blood. 
It should be added that European writers attribute the rhythmic 
spasms which follow distemper to eclampsia, epilepsy or tic, and 
claim that the contractions must be irregular orarhythmic in order 



64 Veterinary Medicine, 

to constitute chorea. English and American writers, however, 
have attributed less importance to this point and consider that 
the constancy and persistency of the contractions in the dog, 
differentiate an affection from both eclampsia and the epilepsy and 
relate it rather to chorea. Tic as illustrated in crib-biting is cer- 
tainly not constant nor rhythmical nor is it a habit beyond the 
control of the will. 

Among other alleged causes of chorea is embolism of the ar- 
teries of the brain or spinal cord. Angel Money went so far as 
to inject a fluid containing arrowroot, starch granules and car- 
mine into the carotids of animals, and produced movements 
closely resembling those of chorea. Another theory connects 
chorea with the rheumatic poisons. Some English writers find 
more than 80 per cent, of all cases in man associated in someway 
with rheumatism, but in Philadelphia, Sinkler found that not more 
than 15 per cent, showed such a relation. D. C. Wood as the 
result of necropsies of a number of choreic dogs reached this 
conclusion : * ' Owing to emotional disturbance, sometimes stopping 
of various vessels of the brain, or sometimes the presence of 
organic disease, there is an altered condition of the ganglionic 
cells throughout the nerve centres. If the cause is removed and 
the altered condition of the nerve cells goes only so far, it re- 
mains what we call a functional disease. If it goes so far that 
the cells show alteration, we have an organic disease of the 
nervous system. ** 

In man the element of sudden fright is awarded a high position 
in the list of causes. 

Lesions, Constant morbid changes of structure have not been 
established in chorea. On the contrary in the many careful ne- 
cropsies of choreic subjects some lesions of brain or spinal cord 
has been almost always found. Dickinson always found con- 
gestion of some part of the brain or spinal cord, but most con- 
stantly of the substantia perforata, the corpora striata and the 
beginning of the Sylvian fissure. In the cord the cervical and 
dorsal regions were the most commonly affected, and preeminently 
the gray matter at the root of the posterior horn. The bilateral 
symmetry of the contractions in cases of unilateral lesions, has 
been held to discredit the theory of embolic origin, yet this may 



Chorea. St, Vitus Dance, 65 

be explained by mutual relation of the ganglia of the two sides 
and their coordination of function. 

The question of the relative importance of the encephalic and 
spinal lesions has been also debated. Chauveau believed that by 
section of the cord in choreic dogs, he had proved that the spasms 
were of medullary origin. Wood on the other hand found that 
the choreic movements persisted after section of the cord, and 
seemed warranted in the conclusion that the movements origin- 
ated in the cord. The probability is, that with the cord intact, 
the primary source of the morbid movement may reside either in 
the encephalon or the cord. In chorea, following distemper, I 
have found marked congestion of the encephalon and its men- 
inges. 

Symptoms, In the dog the twitching may be confined to one 
fore leg, or it may extend to both and then usually implicates the 
neck and head. In other cases the lower jaw, the head, the eye- 
lids or even the eyeballs may be the seat of the twitching motions 
and in still others the hind limbs and trunk are also implicated. 
In nearly all cases the tendency is to a continuous rhythmic 
action, which may moderate without actually ceasing while 
the animal lies down, but which usually stops altogether during 
deep sleep. When it intermits at other times it can commonly 
be roused into activity by exciting the animal in any way. 

In the horse the muscles affected may be those of the head 
and neck, of the fore limb (Hering), of head, limbs and trunk 
(Leblanc). 

In cattle the movements have affected the neck and head and 
the fore or hind limbs (Anacker, Schleg). 

In young pigs the hind limbs, the neck and head have been 
chiefly involved in the spasms (Hess, Vervey). 

If the affection is slight it may not seriously impair the general 
health, but in proportion to its severity and the constancy and 
generalization of the spasms and the consequent muscular waste 
and exhaustion, the animal becomes gradually worn out and 
emaciated and dies of paralysis and marasmus. 

Duration, In favorable cases recovery may ensue in a few 
weeks ; in others the disease becomes chronic and will last for 
months or years. 
5 



66 Veterinary Medicine. 

Treatment. Among the first indications are fresh air and 
wholesome easily digestible food. The removal of any source of 
intestinal irritation should be sought by bland laxatives. As 
the health is usually low, a course of iron tonics is nearly always 
in order. 

Special nervous tonics are next demanded. No agent has a 
better reputation than arsenious acid. Ten drops of a i per cent, 
solution of arsenite of soda may be given daily to the dog or one 
ounce to the horse. If gastric irritation forbids the use of this 
agent, sulphate of zinc may be given in i to 3 grain doses twice 
a day to the dog. In other cases strychnine i^ to ^ oi a grain 
may be given in the same manner. 

Nerve sedatives often have a good efiFect in calming the nerv- 
ous irritability and in this way belladonna, conium, canabis 
Indica, chloral, chloroform, acetanilid, triohal, etc., have been 
employed. 

In the same line are ice bags or ether spray applied to 
the spine for ten minutes at a time, and douche baths of cold 
water, the animal being afterward rubbed dry. This last par- 
takes of the nature of a stimulant and may be classed with gentle 
exercise which at once distracts the patients' attention from the 
nervous infirmity, trains him to control the muscles, gives nor- 
mal exercise and tone to the enfeebled organs and improves the 
general health. 



CONVULSIVE TWITCHING OF THE FACE. 

Nature of phenomenon, arhythmic, hyperezcitability of nerve centres or 
•kin. Nerve section. Head jerking : horse, hard bit, severe check, inter- 
nal pain, exertion, hypersensitiveness. Treatment : nerve section. Tongue 
lolling, etc. Flapping of lower lip. Nasal rhythmic movements. Weav- 
ing, from impatience, rhythmic. Rocking on hind limbs. Resting foot on 
coronet. Pawing. Treatment : eliminate irritation, nerve tonics, sedatives, 
hygienic meabures. 

This has been observed especially in the dog and may be 
easily confounded with chorea. The muscles on one side of the 
face are twitched at more or less regular intervals, or in other 
cases there are sudden opening and closing of the lower jaw. 



Convulsive Twitching of the Face. 67 

The a£Fection has not been satisfactorily connected with any 
special brain lesion, though as in chorea proper and epilepsy, we 
must invoke a special disorder or hyper-excitability of the nerve 
centres presiding over the afiPected muscles. The clonic spasm 
may in some cases be due only to a motor impulse from such ex- 
cited nerve centre, while in others it may be traced backward 
along the afferent nerves to an oversensitive part of the skin or 
other organ. In these last purely reflex forms of the trouble it 
may be possible to correct it by section of the sensory nerves 
involved. 

Convulsive Movements of the Head. 

Convulsive movements of the head as a whole constitute a fre- 
quent form of chorea in the dog. It is especially common in 
horses and shows itself in different forms. A horse with a 
tender mouth, or which has been used with a hard bit, or with a 
heavy hand on the reins, or which has been driven with a check 
rein so short as to be unsuited to its conformation, is liable to in- 
dulge in annoying elevation and depression of the head when 
under the saddle or in harness. The same phenomenon may be 
shown in connection with violent internal pains, as in strangu- 
lated hernia, intussception, or twisting of the bowels. The 
habit once formed is not easily corrected, so that careful treat- 
ment with the view of prevention is especially to be given. 

Another more objectionable, dangerous, and less voluntary 
motion is the sudden jerking of the head upward, or to one side 
when excited under the saddle or in harness. The disorderly 
movements are not, as a rule, seen while the animal is at rest, 
but seem to be produced under the stimulus of exertion. They 
appear to be quite involuntary, and suggest the dread caused by 
the settling or buzzing of an insect about the nose or ears, but 
occur in the depth of winter in the absence of insect life, as well 
as in midsummer. The suddenness and involuntary nature of 
the movement is suggestive of epilepsy, but there is no indica- 
tion of attendant unconsciousness. Prom choreic movements it 
is apparently distinguished, by its presence only when ridden or 
driven. It is unquestionably associated with hypersensitiveness 
of the nerve centres, and yet in many cases it appears to be a 
reflex originating in a specially tender or sensitive part of the 



68 Veterinary Medicine. 

skin or mucous membrane. In more than one instance in this 
college clinic the trouble was corrected by the section of both 
facial branches of the 5th cranial nerves as they emerged from 
the infra-orbital foramina. 

Abnormal Movements of the Tongue. 

Some horses double the tongue^ downward, others upward of 
the bit ; others protrude the tongue and give it a sinuous, ser- 
pentine motion which causes alternate protrusion and retraction. 

Flapping of the Lower Lip. 

This habit of rapid opening and closing of the lower lip so as 
to produce a disagreeable flapping noise by striking it against 
the upper, is seen in many horses and proves, a most objection- 
able trait in harness or saddle animals. 

Rhythmical Movements of the Nose. 

Certain horses apply the protractile end of the nose against the 
lower lip and spend hours in succession in moving it rhythmic- 
ally forward and backward, or from side to side. 

Weaving. Movement like a Bear in a Cage. 

This consists in a lateral rocking of the head and neck, and 
sometimes of the chest as well with alternate stepping on the 
right and left fore feet. It has been supposed to represent the 
movement of the weaver in working a hand loom, or still better 
the movement of a caged wild beast in constant turning toward 
the right and left of the front of his cage. The motions are as 
regular as a pendulum, and 'involve the contraction of corre- 
sponding groups of muscles on the two sides of the body. 

They seem, in some cases, to begin in impatience in waiting 
for the feed, while other horses in the same row are being at- 
tended to first, but when the habit has been formed it may be 
continued most of the time in the intervals between feeds as well. 
Nervous horses and those that are hearty feeders are the most 
subject to this infirmity. 



Vertigo. Megrims. Blind Staggers. 69 

Disorderly Movements of the Limbs. 

Some horses have a habit of continuously raising one hind 
limb, others raise the right and left alternately, rocking the hind 
quarters from side to side, others stand with the heel of one hind 
foot resting on the front of the coronet of the other, while still 
others paw continuously with the fore feet while standing in the 
stall. 

treatment. These various conditions even when begun as an 
expression of impatience, soon become fixed habits, that prove in 
the end virtually uncontrollable by an animal, which has no 
strong will and no consciousness of anything to be gained by re- 
sisting the impulse. They become virtual psychoses. In cases 
in which the habit can be traced to a peripheral irritation, the 
cutting o£F of this by complete section of the a£Ferent ner\*es 
leading to the irritable nerve centre will sometimes succeed in ef- 
fecting a cure. In other cases in which the source of the dis- 
order is probably largely central in the cerebral ganglia, ner\'e 
tonics, and sedatives, and generally corroborative treatment are 
the most obvious means of palliation. Such measures are, how- 
ever, rarely successful. Nourishing food and invigorating out- 
door exercise are useful auxiliaries. 



VERTIGO. MEGRIMS. BLIND STAGGERS. 

Disadnintage of lack of subjective sjrmptoms. Canaea, varied, narootica, 
overloaded stomach, cerebral anemia or hypersemta, degeneration, parasites, 
tumors, jugular obstruction, valvular heart disease, disease of internal ear, 
plethora. Susceptible animals : horse, oz, dog, pig, sheep Direct causes : 
tight collar, or throat-latch, flexion of head, heart desease, pulmonary disease, 
embolisms, gastric distention, hepatic disorder, optic vertigo, aural vertigo, 
injections into ear, rhigolene, chloral, acariasis, seasickness, railroad sick- 
ness, cholesteatoma, coenurus, concussion, degeneration, softening, oestrus, 
lingnatula, narcotics, essential oils, essential vettigo. Symptoms: in irrit- 
able animal, highly fed, and without exercise, crowds pole, his mate or a 
wall, shakes or jerks head, staggers, trembles, rears, plunges, falls, struggles, 
sweats, rolls eyes, recovers. In gastric or hepatic cases, dullness, pendent 
head, swaying gait, dull eye, dilated pupil, pendent lids and lips, leans on 
adjacent object, staggers, falls. In optic cases are obvious causes in transi- 
tion to light, etc., and palliation by covering the eyes. In aural cases, roll- 



70 Veterinary Medicine. 

ing eyes, constrained position of ear, deafness, pharyngeal or Eustachian 
tronbl^, wax or acari in ear, tender or itchy ear. Plethoric cases in spring, 
in overfed, etc. Brain lesions may have fever and disordered innervation, 
bnt retained consciousness, and no marked spasm. Duration. Sheep : para- 
sitic vertigo. Turning. Rotation. Treatment according to cause : restrict 
ration, give exercise, purgative, adjust collar, breast strap, check, avoid 
sudden transitions of light, overdraw check, blinds ; treat nasal, pharangeal, 
ocular or aural trouble ; during attack, stop in shade, cold to head, deplete, 
bleed, purge, shady pasture or light work, bromides, blisters, etc. 

In dealing with vertigo or giddiness in animals we are con- 
fronted by the impossibility of realizing the subjective feelings 
of the animal, as we can so easily ascertain by interrogation in 
the case of man, and thus our conclusions are largely inferences 
drawn from certain unsteady, reckless or uncontrollable move- 
ments, or from an apparent inability to maintain a stable equi- 
librium. The condition is rather a symptom of a variety of 
morbid conditions, functional and structural, than a disease 
sui generis. It may be due to alcoholic or other narcotic intoxi- 
cation, to an overloaded or otherwise deranged stomach, to shock, 
to a stroke of lightning, to disturbances — ^anaemic or hypersemic — 
in the circulation in the encephalon, to degenerations, parasites 
or tumors in the brain, to compression of the jugular veins, to 
valvular or other disease of the heart, to disease of the internal 
ear, to the plethora of spring or early summer, to the qualms of 
sea sickness, to insolation. 

The purely toxic cases are more clearly defined and temporary 
so that they may be eliminated from consideration at present, yet 
their possible occurrence must always be borne in mind by the 
practitioner especially when called to pronounce upon cases of 
vertigo in connection with veterinary legal questions. The 
cases that are due to a persistent neurosis, or to circulatory troubles 
may well be placed in a list by themselves, yet in their legal re- 
lations it is highly important that the practitioner should as far 
as possible discriminate among these as well. 

Susceptible Animals. Vertigo undoubtedly exists among all 
domestic animals. The symptoms by which it is recognized 
have been noted especially in the horse and much less frequently 
in ox, dog, pig and sheep. 



Vertigo. Megrims, Blind Staggers, ji 

Among horses it especially attacks the mature or aged, and 
family harness horses, pampered and irregularly exercised ; (sad- 
dle horses rarely suffer) ; it is more likely to appear for the first 
time in spring though when established it happens at all seasons ; 
it may come on when a horse is driven in blinders and fail to ap- 
pear in the absence of these. 

Causes, ist. Compression of the jugular veins by a too tight 
collar is the cause of one of the simplest forms of vertigo and is 
observed, in growing or fattening animals in which the neck has 
become gradually too large for the collar. The supply of a larger 
and well fitting collar will soon confirm the diagnosis by a com- 
plete and permanent removal of the trouble. In other cases the 
veins may be compressed by undue flexion of the head, the chin 
being drawn toward the breast, or by a throat latch buckled too 
tightly. The substitution of an overdraw check rein, or a loose 
throat latch will show the true source of the trouble. 

2nd. Disease of the valves of the heart or their insufficiency 
from cardiac dilatation is a common cause of vertigo, and may be 
recognized by auscultation and by the general S3anptoms of 
chronic heart disease. 

3d. Disease of the lungs interfering with the flow of blood 
through the right heart and more distantly with the return of 
bipod from the brain. It further effects the brain functions 
through the circulation of a highly carbonized blood, which fails 
to maintain the normal functions of the ganglia. 

4th. Disease of the blood vessels, it may be by emboli 
washed on from clots in the pulmonary veins or the left heart 
and arrested in the vessels of the brain ; it may be by aneurism 
of the anterior aorta as reported of a horse (Lustig) ; it may be by 
phlebitis and thrombosis of the jugulars ; it may be by adjacent 
tumors pressing on the vessels. 

5th. Gastric Vertigo, Abdominal Vertigo, is a comj>lica- 
tion of gastric or hepatic disorder with giddiness and unsteady 
movement. The abdominal disorder may be at once a cause and 
result of the vertigo and it is not always easy to decide which 
predominates. The unsteady movements in certain cases of over- 
loaded stomach in the horse are illustrations of purely abdomi- 
nal vertigo, while on the other hand in vomiting animals nausea, 
retching, emesis, and other gastric disorders promptly attend on 



72 Veterinary Medicine, 

the primary cerebral disorder. There is also a special tendency 
to vertigo in the fat, idle, gorged horse and in those with torpor 
or other disorder of the liver occurring in pampered horses in 
spring and early summer. 

6th. Optic vertigo is a reflex disorder, determined in the ex- 
citable nerve centres by the visual influence. Thus it has been 
seen in horses and sheep from the intense glare of the sun's rays, 
reflected from a lake or river or from white snow or ice, or even 
from the glistening inner surface of the blinds. The effect is in- 
tensified if the animal has just emerged from a dark stable or a 
darker mine. The overdraw check may be a factor by reason of its 
turning the eyes upward and exposing them continuously to the 
full glare of the sun. The sense of motion conveyed through the 
eyes contributes to bring on giddiness and a sense of swimming. 
In man this is notorious, the sense of nausea and vertigo being 
precipitated by looking at the nearby, moving objects in cabin 
or on deck, while it may be retarded by directing the eyes to 
steady distant objects. As dogs, horses and other animals suffer 
from seasickness, and even railroad sickness, this attendant fac- 
tor may be logically accepted. The mere limitation of the field 
of vision, by the use of blinds, and the disappearance in rapid 
succession of near objects behind this narrow screen probably has 
an influence similar to the visible motions in the ship between 
decks, in cases in which these portions of the harness are mani- 
fest factors. 

7th. Aural Vertigo is determined by irritations of different 
kinds affecting the external, middle or internal ear. Experi- 
mental sections show that this is especially due to injuries of the 
semicircular canals. If the horizontal canal is divided there are 
pendulum-like movements of the head alternately to the right 
and left, also lateral rolling of the eyes. If Xh^ posterior canal is 
cut there is a vertical movement, or nodding of the head and 
vertical rolling of the eyes. If the superior vertical canals are 
injured there are pendulum-like vertical movements of the head 
and the animal tends to fall forward. Injury to the anterior 
canal causes diagonal rolling of the eyeball. In destruction of 
all the canals various pendulum-like movements are performed, 
and standing often becomes impossible. Stimulation of one 
auditory nerve is followed by rotation of the eye and rotation 



VerHgo. Megrims, Blind Staggers 73 

of the body on its axis toward the injured side. The passage of 
a galvanic current through the head between the mastoid pro- 
cesseSy or from one external auditory meatus to the other ^ causes 
rolling of the eyeballs. Injection of water violently into a rabbiVs 
ear, or of iced water or of a rhigolene jet, causes rolling of the 
eyes, and rotation of the body toward the side operated on. Dr. 
Wier Mitchell had a similar experience in his own person. If 
the injections are repeated a permanent vertiginous condition is 
induced, and the rabbit or Guinea pig, which has been kept 
in darkness for a few hours and is then suddenly exposed to sun- 
light, is unstable on its limbs for a few seconds. Lucae found 
that with perforation of the membrana tympani, an ear air 
douche y at o.i atmospheres caused abduction of the eyeball, 
dyplopia, giddiness, sense of darkness, and disturbed respiration. 
Vulpain found that a 25 per cent, solution of chloral hydrate 
dropped into the ear of a rabbit caused vertiginous movements. 
McVey records the case of a music teacher who had intense ver- 
tigo induced by the law bass notes of a piano. Crum Brown 
noticed that if a person with bandaged eyes, is rotated for some 
time as on a potter's wheel, he can at first estimate the degree of 
rotation, but after a time he fails to do so, and the rotation may 
be stopped, without checking his sense of whirling. The 
familiar method of subduing an intractable or vicious horse by 
running him rapidly around in a very narrow circular course, 
or by tying head and tail together and letting him circle around 
until he staggers or falls, is another manifest example of this 
aural vertigo. Rabbits and dogs sufiFering from acaria^is of the 
external ear move around in a circle, or even turn somersaults 
tending toward the affected side. Trasbot has found larvae of 
insects (simulium cinereum ?) in the ears of vertiginous horses, 
which he successfully treated with injection of chloroform. Even 
hard pellets of wax pressing on the tympanic membrane have 
been found to give rise to vertigo. 

The explanation of cases of aural vertigo, has been sought in 
the physiological action of the endolymph and perilymph on the 
end filaments of the nerve in the membranous labyrinth, the 
turning of the head from one side to the other having the effect 
of changing the pressure in different parts and establishing cur- 
rents by which the change of position is recognized ; on the 



74 Veterinary Medicine. 

other hand any injury to the canals, by disturbing the pressure 
of the perilymph and interfering with the relative position of the 
canals, and the direction and force of the currents of the endo- 
lymph and perilymph, destroys all proper sense of balance. 
The rotation of the subject as on a wheel or in turning in a 
narrow circle, is held to cause circular currents in and around 
the membranous labyrinth which temporarily destroy all sense of 
equilibrium. Seasickness and railroad sickness are doubtless in 
part due to the swaying motions causing disturbance in the 
canals. The intimate relation between the root of the auditory 
nerve and that of the vagus in the medulla, may serve to explain 
the mutual interdependence of derangement of the stomach and 
liver on the one hand and the occurrence of vertigo on the other. 
Again the relation of vertigo to visual troubles, both as to cause 
and effect, has been attributed to the close relations of the 
ganglia presiding oyer the 3d, 4th, 5th and 6th nerves and those 
of the nerve of hearing. 

There is a degree of deafness in nearly all cases of aural verti- 
go, a circumstance which may be utilized in the diagnosis of such 
cases, the presence of disease of the guttural pouch, or Eusta- 
chian tube, and evidence of deafness on one side, rather than the 
other, may be taken as corroborative evidence of the affection. 
On the other hand James shows that the stone deaf are much 
less subject to both seasickness and vertigo than those that hear. 
The disorder that leads to vertigo implies a retention of a meas- 
ure of the normal function of the internal ear, and therefore of 
hearing, whereas the disease that has caused complete destruction 
of the internal ear and consequent loss of hearing has equally 
destroyed the function of the labyrinth in maintaining a sense of 
balance, and has obviated the aural sensations of equilibrium and 
loss of balance. 

8th. Cerebral Vertigo may be associated with derangement 
of the circulation, or disease in the brain or its meninges. 
Anaemias and congestions resulting from disease or impaired 
function of heart, lungs, arteries or veins have been already 
noticed. It remains to note the presence of cholesteatomata and 
other tumors, and of parasites (cysticercus cellulosa in pig; 
coenurus cerebralis in sheep) in the encephalon, and of injuries 
from concussion, degeneration and softening of the brain sub- 
stance. 



Vertigo, Megrims. Blind Staggers. 75 

9th. Nasal Vertigo has been noted by Cadeac in connection 
with irritation in the nose and especially by the larva of oestrus 
ovis (sheep), and the linguatula (dog, horse). In certain of the 
cases manifested by jerking of the head and diverging to one 
side, the recovery after section of the pes anserina indicates a 
nasal origin. 

loth. Vertigo from Narcotics (alcohol, lolium temulentum, 
belladonna, solanum, various essential oils, carbon monoxide, 
etc)., have been already referred to. 

nth. There remains to be noted cases in which no narcotic 
poison, no mechanical disturbance of the circulation, no visual, 
aural nor nasal trouble, no gastric nor hepatic disorder, and not 
even a distant nervous lesion can be found ; the disease may in 
such cases be ranked for the present as essential vertigo. 

Symptoms. As usually seen in the horse, vertigo often attacks 
the nervous, irritable animal in which the slightest occasion of 
irritation or disturbance causes intense suffering and quick re- 
sponse. This is often aggravated by the plethoric condition of 
the animal, kept on a liberal ration of grain and having little 
exercise. In some forms of the afiFection, however, and especial- 
ly the gastric and hepatic, the subject is dull, carries the head 
low, and lacks vivacity and energy. 

In the first form (the most common in the horse) the animal 
which has been full of life and vigor, slackens his pace and the 
tension on the reins, or stops suddenly, shakes the head, vertical- 
ly or horizontally, or jerks it to one side, trembles, staggers, 
props his legs outward for more stable support, presses against 
the pole, or the other horse, or a wall, leans on the breeching or 
hangs on the breast strap, plunges forward, or to one side, or 
rears up and even falls backward, and comes to the ground. 
Profuse perspiration ensues, the eyes roll, the face is pinched and 
drawn, the prostrate animal may struggle in a helpless way, and, 
if the harness is loosened, he may get up ip a few seconds and 
slowly recover. Often, however, he remains for an hour or 
more, nervous, sensitive, bedewed with sweat, trembling and 
with anxious expression. Such are the more common manifes- 
tations of what is familiarly known as blind staggers. The 
symptoms will vary however, with the cause. 

In gastric or hepatic cases there may be more particularly 



76 Veterinary Medicine, 

dullness and lack of energy, low carriage of the head, unsteadi- 
ness of gait, lack of lustre in the eye, pupils dilated, semi-closed 
eyelids, pendent lips, a tendency to lean on the stall or hang on 
the harness, and though the animal may stagger and fall, there is 
not the abrupt transition from life and energy to the active excite- 
ment and uncontrollable movements. The same remarks apply in 
a measui;e to narcotic vertigo. 

With optic vertigo, the attendant conditions will help to a 
diagnosis. The animal has come from darkness to full sunshine ; 
there is the white, icy or snowy reflection everywhere which the 
animal was facing when attacked, or the glistening lake or river, 
the overdraw check rein, or the blind with perhaps a shining inner 
surface. The pupil is closed, and the eye is rolled back or oscil- 
lates in one direction or another. The symptoms are checked by 
covering the eyes or removing the subject into a dark building or 
even into the shade of a tree or shed. 

With aural vertigo there may be similar rolling of the eyes, 
without the pupillary closure, the ear may be drawn down or 
back, and the shaking or jerking of the head is likely to be a 
marked feature. If there is more motion of one ear than the 
other, if the head is jerked to the one side, if there is a measure 
of deafness in the one ear (to be ascertained rather in the inter- 
vals between attacks), if there is disease of the pharynx, the Eu- 
stachian tube or pouch, or swelling about the root of the ear, if 
there is wax, scurf, or acarus in the ear, if the animal rubs it fre- 
quently, aural vertigo may be suspected. 

Nasal vertigo. Those forms in which the head is jerked hor- 
izontally, vertically, or diagonally, the animal pressing against its 
mate or the pole, or outward in the harness, and getting out of its 
track, even if it should step short of falling, and which appear 
only during work, or are aggravated by exertion, have been 
attributed to lesions of the ear (Fleming), but in some cases they 
can be warded ofiF by wearing a net over the nostril, and can be 
entirely stopped by complete transverse section of the pes anse- 
rina, so that in a certain number at least they must be accounted 
nasal. These are not usually attended by sneezing. The simple 
expedient of driving with a rather close net over the nostril may 
enable one to diagnose many of the purely nasal forms. 

Plethoric vertigo may be suspected when the attack comes on 



Vertigo, Megrims. Blind Staggers, 77 

in spring, in a fleshy or fat horse, over-fed and little exercised, 
when there is dark red congestion of the nasal mucosa and con- 
junctiva, and a subsidence with rest. 

In the vertigo of brain lesions, the acute forms are attended by 
fever and marked signs of delirium or disordered nervous func- 
tions, while in the chronic forms there may be permanent hyper- 
aesthesia, or anaesthesia, general or with rather diffuse limits, and 
the vertiginous attacks repeat themselves frequently irrespective 
of weather, though they may be precipitated by faults of feeding, 
indigestion, severe exertion, or some of the other exciting causes 
above mentioned. 

These cases are to be distinguished from epilepsy by the ab- 
sence of any spasmodic contraction, aside from the jerking of the 
head and rolling of the eyes, and by the fact that consciousness is 
retained throughout. During the attack the animal may fail to 
respond to irritation of the nasal mucosa, but this appears to be 
due to the fact that his whole attention is engaged with k more 
serious trouble. 

The duration of an attack is from one to two, or exceptionally 
five minutes. The form which is represented by jerking of the 
head and deviation from the direct line of motion may continue 
so long as exercise is kept up. 

In the nasal vertigo of sheep and dogs, due to parasites, 
sneezing, and congestion of the mucosa are to be looked for. 

In the cerebral parasitic vertigo of sheep and pigs, the 
symptoms vary according to the seat of the parasite. These may 
be blindness, turning in a circle, moving straight ahead regard- 
less of obstacles, jerking upward of the head with nose protruded, 
hemiplegia, hemiansesthesia, cross hemiplegia, cross hemianaes- 
thesia, and any one of the many forms of paralysis, or exagge- 
rated nervous action. The animal usually turns to the side on 
which the parasite lies and is paralyzed on the opposite side of 
the trunk. A peculiarity of these cases is that while the symp- 
toms are continuous, yet there are periodic aggravations which 
bear no relation to feeding, exertion or excitement, but depend 
on the protrusion at intervals of the heads of the parasites into 
the brain substance. If there are several parasites in the brain 
and they do this at different times the symptoms are liable to 
vary according to their seat, and the special organ which is irri- 



78 Veterinary Medicine, 

tated. This variability of syjnptoms is suggestive of parasitism. 
While turning around in a circle has been already noticed 
there remains, in certain cerebral forms, the peculiar phenome- 
non of the animal rotating rapidly on its longitudinal axis. The 
patient falls on its side and rolls over and over. Among the 
brain lesions with which it has been experimentally identified are 
injuries to the middle peduncles 0/ the cerebellum ^ or of the supero- 
external portion 0/ the cerebral peduncles, or of the posterior part 
of the encephalon, or of different parts of the hemispheres. 

Cases of vertigo that occur without an}* appreciable lesions have 
been named essential vertigo, Guibert has attributed some cases 
to irritation of the lower part of the limbs by contact with the 
litter but this could only occur in an animal in which the nervous 
system was in a morbidly excitable condition. 

Treatment, The prophylactics and therapeutics of vertigo 
will vary with the cause. The diagnosis of the cause is there- 
fore the most important step. In pampered, overfed, idle horses 
a reduced ration and daily exercise or work will often suffice. 
It is usually desirable, however, to remove intestinal irritants 
and deplete the vascular system by an active purgative. If the 
attacks appear only in Spring this care should be especially given 
at such seasons. A tight or badly fitting collar should be cor- 
rected, also a position of the breast strap which causes it to press 
on the jugular veins. A short bearing rein causing undue 
flexion of the head must be lengthened or abandoned. A too 
dark stable should be avoided, also the sudden exposure to white, 
dusty roads and, still more so, to the glare of snow, ice, or 
water. A short, overdraw check rein, turning the eyes up 
directly into the sun*s rays, or blinds with a glistening inner sur- 
face may require correction. It may be better to abandon blinds 
altogether, or to cover the eyes by a piece of leather, 2 to 4 
inches wide, extending across the forehead from one eyef to the 
other ; or a sunshade attached to the headstall may be worn so 
as to protect the eyes. Horses which become seasick or carsick 
may sometimes be helped by covering the eyes. Other indica- 
tions would be to treat any existing trouble which interferes with 
a normal circulation in the brain (pulmonary congestion, aneu- 
risms, tumors pressing on carotids or jugulars, phlebitis, etc.), 
and such as affect the ear (disease of the pharynx, guttural 



Vertigo. Megrims. Blind Staggers. 79 

pouches, adjacent glands, petrous temporal bone, membrana 
tympani, external ear). Indurated wax, insects or insect larvae 
may be removed by careful irrigation with warm water, and per- 
haps by chloroform. Nasal parasites must be washed out or de- 
stroyed by benzine, and any hyperaesthesia of the nasal mucosa 
maybe met by covering the nostril with a net, or radically by 
cutting the facial branch of the 5th nerve as it emerges from the 
infra-orbital foramen. 

When attacked the horse should be at once stopped and put 
under the shadow of a roof or tree, or in their absence, a blanket 
or lap robe may be used to cover his eyes. If there is danger of 
falling remove the harness, and secure a soft piece of ground, 
free from stones or other hard bodies. Cold water applied to the 
head will sometimes check. A common practice is to bleed from 
the palate, and in plethoric cases especially, and in such as are 
dependent on congestion, tumors or other lesion of the brain it is 
to be commended. The action will be rendered more prompt and 
efFective if the blood is taken from the jugular. A laxative diet, 
and carefully reg^ulated work are desirable to obviate the tendency 
to the a£Fection, and this may often be accomplished by a run at 
pasture. Otherwise daily small doses of Glauber salts in the feed 
may suffice. Bromides may be used to calm nervous excitement. 

In cases of gastric vertigo an active cathartic, followed by 
smaller laxative doses or a laxative diet and a course of bitters 
may prove useful. Such cases should never be worked on a full 
stomach but should be left at rest at least for an hour after a meal. 

In aural vertigo special attention must be given to the throat, 
and external ear. Bromides may often be useful, and sometimes 
benefit may be derived from an occasional blister or light firing 
back of the ear. 

In coenurus cerebralis in sheep the only resort is to trephine 
and remove the parasite. 



CONCUSSION OF THE BRAIN. 

Definition. Causes : leaps, trips, falls, blows. Symptoms : fall, insensi- 
bilitj, flaccidity, suspended respiration, tumors, vomiting, recovery, signs 
of cerebral congestion. Pathology : anaemia followed by congestion. Diag- 
nosis : from fracture, epilepsy. Treatment : quiet, rubbing of limbs, am- 
monia, cold to head, or heat ; for congestion, bromides, depletion, -ice pack, 
derivatives. 

Definition, Concussion is the condition produced by mechani- 
cal jar or shock of the cerebral mass, and manifested by modifi- 
cation of the brain functions of any grade from a simple dazed 
condition to that of complete unconsciousness. 

Causes. The most familiar cause is the stroke of the butcher's 
pole ax, producing sudden and absolute insensibility. A horse 
in leaping, trips and falls on his head or running against a wall 
sustains a concussion, which leaves him for some seconds without 
any signs of life. The same will happen to other animals, but 
above all to rams which in their combats, back for a number of 
yards and running together meet with a shock from' the efiFect of 
which even their thick skulls cannot save them. Other blows 
upon the head operate to the same end. 

Symptoms, Concussion is manifested by different grades of 
symptoms. At first there is usually a fall with complete insen- 
sibility. The animal lies flaccid, utterly insensible to external 
irritation and there is suspension of respiration. The heart con- 
tinues to beat and a frequent weak pulse may be often detected. 
In slight cases, breathing may be re-established at the end of a 
minute or two, with muscular tremors and movements of the 
limbs ; then the animal rises, shakes his head, neighs, and walks 
at first unsteadily and afterward with greater and greater firmness. 
In vomiting animals, emesis occurs. 

In some cases this may be followed, after an hour or two, by 
signs of congestion, heat of the head, redness of the eyes, irri- 
tability, or dullness and stupor and perhaps muscular twitching. 
This may improve or it may terminate in death preceded by 
spasms, general convulsions, rolling of the eye balls, and stupor 
or coma with general muscular relaxation. 

The primary condition is usually an anaemia of the cerebral 
80 



Concussion of the Brain, 8i 

matter as seen in the brain of the animal suddenly killed by the 
blow of a hammer. The return of consciousness or semi-con- 
sciousness is connected with the resumed freedom of the cerebral 
circulation. The later convulsions, stupor or coma, usually imply 
active congestion or the effusion of blood on the brain surface, or 
in its substance. 

Diagnosis from fracture must be made mainly by manipula- 
tion of the bone in the seat of the blow, and by the absence of 
the increasing stupor and coma which attend on pressure from 
a gradually increasing blood clot. Prom epilepsy it is to be dis- 
tinguished by the evidence of mechanical injury, by the absence 
of spasms at the first, by the suspension of breathing and the 
absence of froth about the lips. 

Treatment. Keep the patient still and prostrate until there are 
signs of returning respiration and free cerebral circulation. This 
may be hastened, however, by active rubbing of the limbs and 
l>ody, by giving guarded inhalations of ammonia, or even by 
friction of the skin with ammonia and oil. Sometimes reaction 
is favored by dashing cold water on the head, while in other 
cases hot water to the poll will prove more effective, or the 
two may be used alternately with good results. 

If, after partial recovery, there is marked restlessness, or ir- 
ritability it may be met with bromides. If secondary uncon- 
sciousness supervenes effusion of serum or blood is to be feared, 
or extreme congestion, and blood may be drawn from the jug- 
ular or by cups from the cranium, and ice bags or cold water 
may be applied to the head. Hot foot baths or mustard embro- 
cations applied to the limbs, and even derivation toward the 
bowels may be used. The indications for treatment come to be 
for meningo-encephalitis. 



LIGHTNING STROKE. ELECTRIC SHOCK. 

Fatal. Non-fatal. Herbivora at pasture under tree. Symptoms : dazed 
for a few minutes, unconscious for hours, permanent paresis or paralysis- 
Lesions : lines of burned hair, skin or muscles, rigor mortis slight, decompo- 
sition rapid, bluish black venous and capillary congestion, extravasations, 
blood fluid. Diagnosis. Treatment : ammonia, ether, alcohol, caffein, 
nerve stimulants. 

While a stroke of lightning is usually fatal, yet in certain cases, 
the victim is but temporarily stunned and recovers with more or 
less remaining paralysis. The subject has also great importance 
in connection with the claim of the owner against a company which 
may have insured his stock against lightning. 

Any animal may be struck, but the herbivora which are turned 
out to pasture are especially liable to such injuries, because they 
seek shelter under trees, which operate as lightning rods. 

Symptoms, In slight cases of shock whether by lightning or 
the current of a hanging live electric wire, the subject may be 
simply dazed and may or may not fall to the ground, and recover 
itself in a very few minutes. In other cases there is a more 
violent shock which prostrates the animal to the earth, where it 
may lie unconscious for some hours and yet quickly and com- 
pletely recover. In still other cases after such prostration re- 
covery is incomplete and the animal remains affected with pare- 
sis or paralysis of one or more, commonly of both hind, or all four 
limbs. In the more violent shocks death is instantaneous. 

Often the impact and course of the current are marked by 
visible lesions. Sometimes the skin is wounded exposing a bluish 
black tissue beneath. More commonly there is an area of burnt 
hair, or straight, radiating or angular lines of raised and frizzled 
hair marking the course of the current. In a horse killed by an 
electric light wire in Ithaca recently the current had burned to a 
depth of several inches in the muscles of the shoulder which 
rested on the wire. 

Lesions are often rather indefinite. There may be no appre- 
ciable change in the nervous system. Rigor mortis is slight ; it 
passes off rapidly and decomposition sets in early. The venous 
system and capillaries are usually filled with liquid blood of a 
82 



Lightning Stroke. Electric Shock, 83 

dark bluish black color, and at intervals are points, spots and 
patches of blood extravasation. The uniformly liquid state of 
the blood is one of the most marked phenomena of death from 
electricity. The dark blue congestion of the radical veins is also 
very pathognomonic, the part struck or traversed by the main 
current, being the seat of the most elaborate arborescent network. 
This arborescent appearance of the dark colored veins, and the 
petechiae are often marked in the internal organs (brain, kidneys 
liver, lungs). 

Diagnosis, The environment of the animal will often clear the 
diagnosis. The patient is found helpless, or dead under a tree 
by a pole, or under a hanging wire, and if a tree there are evi- 
dences of the electric shock in scattered leaves and branches, 
stripping off of the bark, or perhaps rending of the tree in pieces. 
In case of wires attached to or passing near such a tree, the sup- 
porting poles show similar splitting and rending. Add to these 
the fluidity of blood in the carcase, the thickly ramifjring network 
of the minute dark bluish, red veins, the petechise and the com- 
parative absence of cadaveric rigidity, and we have a picture very 
significant of lightning stroke. 

Treatment in such cases is according to the condition. The 
primary unconsciousness is met by inhalations of ammonia or 
ether, or the injection of brandy or alcohol subcutem. Caffein, 
atropine or hyoscyamin may be used as substitutes. If conscious- 
ness returns recovery is usually rapid and complete. Should 
paresis or paralysis remain it must be treated like any ordinary 
case of these affections. 



INTRACRANIAL HAEMORRHAGE AND THROMBOSIS. 
APOPLEXY. SOFTENING OF THE BRAIN. 

Definition. Cauaes : Nature : intracranial rupture, with pressure, serous 
effusion, excessive congestion, experimental cases, ansemia from pressure, 
comparative immunity of horse, heart disease, Bright's disease, atheroma, 
degeneration, emboli, age, blood tension, severe exertion, excitement, con- 
cussion, insolation, venous obstruction, toxins, neoplasms. Lesions : blood 
clots, small and multiple, large and solitary, brain absorption, cavities, cysts. 
Symptoms : dullness, swaying, trembling, elevation of head, turning in circle, 
sudden fall, spasms, unequal dilated or contracted pupils, eyes turned to 
affected side, congested or anaemic mucosae, stertor, puffing cheeks except 
in solipeds, pulse slow, soft, full, vomiting, stupor, coma, unconsciousness, 
paralysis, monoplegia, hemiplegia, sequelse. Diagnosis: sudden uncon- 
sciousness, with little spasm, but paralysis, history, sign of trauma, deep 
coma, eyes turned to one side, pupils unequal, stertor, slow breathing and 
pulse ; from uraemia, pulmonary apoplexy, oedema or anthrax. Treatment : 
bleeding, ice pack, snow, cold water, rest, derivatives to limbs, later purge, 
bromides, potassium iodide, tonics, open air life. 

Definition, Cerebral apoplexy has been defined as a sudden 
loss of sensation and voluntary motion, from pressure originating 
within the cranium and followed by paralysis, often unilateral. 
The definition is somewhat insufficient as regards the early symp- 
toms as the same conditions attend on convulsions and epilepsy 
(haut mal), and it is only by excluding these by their character- 
istic features of sudden seizure with clonic spasms and th^ir inter- 
mittent and paroxysmal habit that we reach an easy and satisfac- 
tory distinction. Later the paralysis tends to identify the apo- 
pletic attack. 

Causes and Nature, The immediate cause and essential lesion 
of apoplexy has been generally held to be the rupture of an intra- 
cranial artery and the formation of a considerable blood clot which 
presses upon (and abolishes the functions of) the brain. There 
are cases, however, in which the characteristic symptoms are 
present, and yet a complete recovery ensues at an early date, too 
early to allow for the absorption of a considerable clot. Moreover, 
in fatal cases perhaps no blood clot is to be found, but in place a 
serous effusion, or an internal congestion which exercised the 
fatal pressure on the brain. So far, therefore, as clinical phe- 
84 



Apoplexy and Softening of the Brain, 85 

nomena are concerned, we must allow that apoplexy may arise 
from any sudden pressure on the brain substance. Pagenstecher 
produced the s5anptoms of the disease by injecting, at a regulated 
pressure, melted wax and tallow between the skull and dura 
mater in the dog. In the moderate cases there were drowsiness, 
psychic depression and general muscular weakness. In the more 
severe ones there were added sleep and unilateral paralysis. In 
the more extreme cases death followed in a few hours after coma 
set in, though in some of these a partial recovery ensued if the 
waxy mass was scooped out before the fatal symptoms appeared. 
Cases ended fatally only when the injection pressure equalled 
that of the blood, and convulsions occurred only when the pres- 
sure was unsteady. The temperature fell as it does in apoplexy 
in man, at the outset, but it continued falling to the fatal issue 
contrary to what takes place in man. 

Duret injected water into the cranium of animals so as to pro- 
duce great tension of the occipito-atloid membrane causing there- 
by arrest of the respiration and slowing of the heart's action. On 
tearing the membrane so as to allow escape of the water, respira- 
tion began anew and consciousness was gradually restored. 

Edes sustains the view that apoplexy is directly due to anaemia 
of a lesser or greater portion of the brain substance, and that this 
need not be in any one particular seat nor of any definite extent. 
This anaemia is usually induced by pressure and may be caused 
by effused blood, or serum, or by the extreme congestion due to 
narcotic poisons, or other cause. Embolism of a cerebral vessel, 
however, by cutting oflF the blood from the part of the brain 
which it supplies inay give rise to the apoplectic phenomena. 

Friedberger and Frohner found apoplexy quite frequent in 
sheep, ox, and dog, and rare in the horse, although more subject 
to the violent exertion which they put in the front of all causes. 
It is probable that the sluggish, pampered life of the first three 
animals, and the tendency to fatty degenerations and heart disease 
introduces a special predisposition as it does in man, while the 
horse, inured to an open air life and a vigorous muscular condi- 
tion, is comparatively immune. Bright's disease is a common 
cause in the human subject, with its resulting cardiac hypertrophy. 
The degenerations attendant on these conditions and especially 
fatty change (atheroma) in the walls of the cerebral arteries. 



86 Veterinary Medicine, 

pave the way for their rupture and for blood effusion. Emboli 
also carried from the diseased heart not only cut off the blood 
from the parts supplied by the plugged arteries, but increase the 
blood tension on the cardiac side of the obstruction and endanger 
rupture at any weak part. Thus they may cause apoplexy from 
anaemia without rupture or apoplexy from the pressure of effused 
blood. 

Age which is such a notorious factor in man is nol without its 
inflence in the lower animals. It is in the old that we mostly 
see disease of kidneys and heart and the degenerations of the tis- 
sues, including the brain and its vessels ; in these, therefore, rupt- 
ture and extravasation are the most frequent. 

The other causes are mostly connected with increased blood 
tension with or without a debility of the vascular walls. Violent 
exertions as in racing, coursing, dragging heavy loads up hill or 
on heavy ground, severe excitement, cerebral concussion, insola- 
tion, and intense congestion of the brain substance have all been 
recognized as causative factors. The compression of the jugulars 
by a small collar, the violent straining attendant on parturition, 
or constipation, and even the retrocession of blood from the sur- 
face when exposed to extreme cold, may contribute to the final 
rupture. 

In infectious diseases in which the toxic products tend to pro- 
duce profound modifications in the blood and tissues, extravasa- 
tions are met with in the brain as in other organs. Thus they are 
seen in anthrax, Texas fever, petechial fever, etc. 

Then the formation of neoplasms in the brain may be the oc- 
casion of the rupture of the vascular walls and apoplexy. 
Hsematoma of the dura in the dog (Friedberger and Frohner), 
cholesteatohiata in the horse, and carcinoma may be apparent 
causes. 

The effect of mechanical injury must be admitted, as blows 
on the head, injuries from an ox yoke, and concussions during 
the battles of rams and bulls. 

Lesions. Blood extravasations may be found at any part of the 
brain : a. into the brain substance ; b. into the ventricles ; 
c. from the pia mater ; d. into the arachnoid sac ; e. between 
the skull and dura mater. It is especially common in connection 
with the ganglia adjoining the ventricles ; the corpus striatum,. 



Apoplexy and Softening of the Brain. 87 

optic thalamus, the corpora quadrigemini, the fornix. In other 
cases the cms cerebri, pons, medulla oblongata, corpus calosum. 
In other cases the convolutions of the cerebrum or cerebellum 
suffer. The amount of effusion may be limited to a few drops or 
it may cover an extensive area and cause considerable flattening 
of the brain substance. 

When capillary haemorrhages are present — the size of a millet 
seed or a pea — Friedberger and Frohner have usually found 
them multiple, but when large enough to form distinct clots 
they are usually single and confined to one side. If a clot, in- 
volving the brain substance, is small, it merely separates the 
nervous fibres, but if larger, the cerebral tissue is broken down 
in the mass of clot, discolored, torn and softened. If the patient 
has survived the first attack the clot passes through the different 
stages of discoloration, brown, brownish yellow, yellow, and may 
become fibrous forming a distinct cicatrix, with loss of brain sub- 
stance. In connection with the partial absorption of the effused 
blood, cavities may be filled with a serous fluid (apoplectic cysts), 
and these may show multiple loculi. The nerve fibres which 
lead to an old standing lesion are usually degenerated. 

When effused into a ventricle, blood is less readily absorbed 
and tends to remain as a flattened discolored layer. 

Extravasation between the dura mater and the cranium is 
probably always the result of direct mechanical violence. 

Symptoms, Premonitory indications of apoplexy are less com- 
monly recognized in the lower animals than in man, doubtless 
largely because of the impossibility of appreciating subjective 
symptoms. The first observed indications are usually dullness, 
some lack of coordination of movement, swaying, unsteady gait, 
trembling and a tendency to deviate to one side or to move in a 
circle. In the majority of cases, however, the first symptoms 
noticed are a complete loss of consciousness or nearly so, a 
sudden fall and often more or less convulsive movements of the 
limbs aggravated by any excitement. . The eyes remain dilated, 
the pupils enlarged or sometimes contracted, and in case of uni- 
lateral effusion the axis of vision of both eyes is turned to the 
affected side, right or left. The pupil of one eye is likely to be 
more widely dilated than that of the other. Rolling of the eye- 



88 Veterinary Medicine. 

balls is not uncommon. Convulsions may occur, the head and 
hind limbs being drawn back forcibly as in oposthotonos, or the 
animal may lie flaccid and comatose from the first. The nasal, 
buccal and orbital mucous membranes are usually congested, 
deep red or livid, yet sometimes they are anaemic and pale 
(Shock). The breathing is usually characteristic, being deep, 
slow, labored, irregular and stertorous and accompanied by 
puffing out of the cheeks at each expiration (except in solipeds). 
Yet there are cases in which stertor is absent. The pulse is 
usually slow, full and soft, and, in the carotids, throbbing, but 
it may be weak and imperceptible. There may be complete un- 
consciousness, and again from the first, or nearly so, there may 
be a slight response to a stimulus, which cannot be referred alto- 
gether to reflex action. In vomiting animals, emesis may ensue. 
Stupor and coma are more or less marked, though liable to inter- 
missions under any cause of irritation. 

Along with the above symptoms the spasms and sequent 
paralysis, are significant. If confined to given muscles or groups 
of muscles (monoplegia) it usually implies pressure on some 
special cortical convolutions presiding over thiese muscles, and 
convulsions are to be expected. If there is hemiplegia it is sug- 
gestive of implication of the medulla or pons on the opposite 
side, or of a clot on the corpus striatum or extensively on one 
side of the cerebrum. A clot in the lateral ventricle tends to 
profound coma. So liable, however, is pressure to be extended 
from one side of the brain to the other, and irritation on the one 
side to rouse a corresponding condition on the opposite side, or 
in related ganglia, that deductions of this kind cannot always be 
implicitly reli^ on. 

Though an animal should recover from an attack there is liable 
to remain some modification of the nervous functions, partial 
anaesthesia, circumscribed paresis, dullness, lack of energy, irrit- 
ability, or muscular atrophy. 

Cerebral embolism and thrombosis and their sequelae, infarction 
and softening, give rise to corresponding symptoms, according to 
the seat of the lesion, and like lesions of the blood vessels pre- 
dispose to subsequent attacks. 

Diagnosis is based largely on the appearance, usually sudden 



Apoplexy and Softening of the Brain, 89 

but sometimes slow, of a more or less profound unconsciousness, 
attended or followed by paralytic troubles. The history of the 
case may assist, any blow on the head, or sustained by falling, 
striking a wall or post, or wearing a yoke, is to be noted. Any 
extraordinary exertion or excitement must be considered. Any 
sign of injury about the head ; the congestion of the cephalic 
mucous membranes in contrast with the pallor of shock ; the 
onset of the attack without convulsions (or with them as in epi- 
lepsy) ; the deep coma indicating cerebral haemorrhage or nar- 
cotic poisoning ; the absence of the odor of alcohol, opium, or 
other narcotic from the breath ; the turning of the eyes to one 
side and the inequality of the pupils on the two sides ; the turn- 
ing of the head to the same side. as the eyes ; the slow, labored, 
usually stertorous breathing ; the slow, full, soft pulse ; the oc- 
casionally rigid condition of the muscles and finally the paralysis, 
hemiplegic and less frequently monoplegic or paraplegic, make 
up the diagnostic picture. 

Ungmia and diabetic coma may be excluded by examination of 
the urine, pulmonary apoplexy or adema by the predominance of 
respiratory troubles, and fulminant anthrax by the examination 
of the blood and by the fact that this disease does not prevail in 
the locality. 

Treatment is very unsatisfactory in the lower animals, as the 
disease is very fatal, and unless recoveries are complete, they are 
not pecuniarily desirable. It is only in the slighter cases, there- 
fore, that treatment can be recommended. At the very outset no- 
thing is better than a full bleeding in a large stream from the 
jugular vein or temporal artery. Ice, snow, or cold water should 
meanwhile be applied to the cranial region. Absolute rest should 
be given, any harness that would impede circulation or respiration 
removed, and hot water or stimulating embrocations applied to 
the limbs. 

When consciousness returns and the patient can swallow, an 
active purgative may be administered, or barium chloride or 
eserine may be given subcutem. Any recurring heat of the head 
may be met by renewal of cold applications, and the force of the 
circulation may be kept in check by small doses of bromides or 
aconite. In case of the formation of a clot, iodide of potassium 
and other alkaline agents may be resorted to. Quiet and the 



90 Veterinary Medicine, 

avoidance of all excitement together with a laxative non-stimu- 
lating diet must be secured throughout. A course of vegetable 
or mineral tonics and an occasional blister to the side of the neck 
may prove a useful sequel. 



CEREBRAI. HYPER-^MIA. 

MENINGO — ENCEPHAUC CONGESTION. 

Passive and active hypenetnia. Causes : passive : obstacles to return of 
blood : anaemia : active : brain excitement, sunstroke, violent exertion, fear, 
abdominal tympany, ptomaines, narcotics, lead, darnel, millet, leguminous 
seeds partly ripened, tumors, parasites. Symptoms : horse : variable, vertigo, 
stupor, convulsions, apoplexy, irritability, disorderly movements, strong, 
hard pulse, congested mucosae, heat of head, dullness, drowsiness, lethaigy, 
coma, alternating periods of violence, aggravated by what tends to increase 
vascularity of brain, congested optic disc : cattle : parallel, with special heat of 
horns : dogs : similar, with desire to move, or wander, or has nausea,howls, 
snaps. Treatment : cold to head, derivation to limbs and bowels, chloral, 
bromides, ergot, bleeding, darkness, coolness, non -stimulating food. 

Congestion of the encephalon is treated here as a pathological 
entity, though it cannot always be distinguished clinically from 
some forms of vertigo on the one hand and from the milder types 
of apoplexy or encephalitis on the other. It has been divided 
into passive or venous hypercemia and active or arterial hyperemia. 

Passive hyperemia, as shown under vertigo and apoplexy is a 
common result of a tight collar, a tight strap used for crib-biting, a 
too short bearing rein, dilation or valvular disease of the right 
heart, or disease of the lungs, violent efforts in running, draught, 
etc. It tends to be associated with arterial anaemia on the princi- 
ple that the closed cranial cavity can only admit a certain amount 
of blood and if an excess accumulates in the veins and capillaries, 
this must be compensated first by the movement backward to the 
spinal canal of the cerebro-spinal fluid, and second by the dimi- 
nution of the blood in the cerebral arteries. 

Active hyperemia, may be brought about by any excitement 
which especially affects the brain. This has been already noted 
in connection with insolation (sunstroke). It may result from 



Cerebral Hyperemia 91 

severe exertion during hot weather, in a violently contested 
race, in drawing a heavy load up hill, or in harsh training. 
Violent exertion just after a meal is especially injurious. Also 
the excitement of travelling by rail, or that caused by proximity 
to locomotives, to discharges of firearms and to other causes of 
great fear ; encreased blood tension in the cerebral vessels in 
connection with hypertrophy of the left ventricle, or obstruction 
in other vessels (of the limbs) so as to direct the force of the 
current into the carotids, the expulsion of blood from the 
splanchnic cavities by gastric or intestinal tympany, or over- 
loading of the paunch, and irritation of the brain by ptomaines 
and toxins in certain infectious diseases (rabies, canine distem- 
per, etc.) In the same way vegetable narcotics (opium, etc.) 
produce congestion. Among the most common causes of con- 
gestion are lead, poisoning by lolium temulentum, partially ripened 
lolium perenue, millet, Hungarian grass, and partially ripened 
seeds of the leguminosae (chick vetch, vicia sativa.) Other 
causes are the presence of tumors (cholesteatoma) and parasites 
coenurus, cysticercus) in the brain. 

Symptoms, Cerebral hypersemia, like other brain disorders 
may give rise to a great variety of symptoms, according to the 
condition of the animal and the susceptibility of its nerve centres. 
Some cases have the characteristic seizures of vertigo, others the 
manifestations of heat stroke, and others, epileptic explosions or 
apoplectic symptoms. For these see under their respective head- 
ings. In other cases the symptons are those of encephalo- 
meningitisbut moderate in its type and often tending to a transient 
duration, or to prompt resolution and recovery. 

Horse. There is manifest change of the nervous and intellect- 
ual conditions, which may show itself by irritability of restless- 
ness, by pushing against the wall, by hanging back on the halter, 
by trembling, shaking the head, neighing, payving and, in ex- 
ceptional cases, by rearing, biting or kicking. The pulse is hard 
and full, the heart's impulse strong, the beats in the carotids and 
temporal arteries being especially forcible, and the buccal, nasal 
and orbital mucosae are strongly congested. Heat of the head is 
usually a marked feature. While usually very sensitive to touch, 
noise or light, the animal may be dull or drowsy, and in spite of 
its marked sensitiveness, it is then inert or lethargic and indis- 



92 Veterinary Medicine, 

posed to any active exertion. Friedberger and Frohner say that 
the habitual comatose condition alternates at intervals with 
periods of violent excitement during which the animal pushes or 
dashes against the wall, grinds the teeth, rears, paws, kicks, bites, 
etc., and then relapses into the state of coma. When the disease 
reaches this stage it may be questioned whether we are not deal- 
ing rather with acute encephalitis. 

In active congestion the symptoms are always aggravated by 
whatever tends to increase the vascular tension in the brain. 
Active exertion, draught, the pendent position of the head, the 
recumbent position on the side with the head as low as the body 
or lower, aggravate all the phenomena and render the animal more 
helpless. 

The following table slightly modified from Spitzka serves to 
point out the distinctions between ansemia and hypersemia : 



Symptoms. j In Cerebral Anaemia. 



In Cerebral Hypersmia. 



Usually small or medium. 
Normal or nearly so. 



Pupils. I Usually dilated and mobile. 

Respiration. \ Often interrupted by a deep 

breath or sigh, even when 

I at rest. 
Activity. ! Lassitude. Restless, but indisposed to 

; I exertion. 

Temperament. | Lethargic with exceptions. Irritable with exceptions. 
Intelligence. Senses impaired. Impaired. 

Elevation of head! Aggravates symptoms. No effect, or improvement. 

Recumbent, de- Amelioration. | Aggravation. 

pendent head. 
Straining. I Not necessarily aggravated. Aggravated. 



Cattle show the same general congestion and heat of the head, 
ears and horns, congested mucosae, fixed eyes, and pupils, indis- 
position to follow the herd, irritability, and dullness with often a 
disposition to lie down. This may go on to violent bellowing, 
pushing against the wall, grinding of the teeth, working of the 
jaws, rolling of the eyeballs, and violent dashing in diflFerent 
directions regardless of obstacles. 

Dogs show the same restlessness and excitability, congested 
head, eyes and nose, frequent movement from place to place, a 
desire to wander off, and it may be spasms. If there has been 
any gastric disturbance vomiting usually supervenes. As in the 



Cerebral Hyperemia, 93 

larger animals the disease may go on to more violent symptoms, 
and the animal howls, rushes in different directions, and ma}"^ 
snap at imaginary objects, or at any one who interferes with him. 
His movements are liable to be unsteady, uncertain and swaying. 

In all cases the ophthalmoscope reveals a congestion of the 
optic disc. 

In the different animals too, acute cerebral hyperaemia tends to 
merge early into encephalitis with exudation and pressure, at- 
tended by stupor, coma, somnolence or profound lethargy. 

Treatment. In slight cases of cerebral hyperaemia, it may be 
sufficient to apply cold to the head with a stimulating fomenta- 
tion to the limbs, and an active purgative, with chloral or bro- 
mides. Ergot in full doses has often an excellent effect. 

In the more acute types of the disease, bleeding is the first and 
most efficient measure. A full abstraction from the jugular 
will relieve the vascular tension and relieve the circulation on the 
brain. It has been counselled to avoid this when comatose 
S3rmptoms have set in, and in some prostrate conditions a large 
and rapid abstraction of blood may fatally increase the prostra- 
tion. In other cases, however, the less rapid abstraction will 
improve at once the intracranial circulation and nutrition, and 
solicit the reabsorption of the exudate which produces sopor and 
coma. 

A purgative is one of the most efficient derivatives, the deter- 
mination of an excess of blood to the bowels and of an abundant 
serous discharge into their interior acting as a valuable depletion, 
and abstraction of blood from the over-excited brain. At least a 
half more than the usual dose mast be given, and may be supple- 
mented by an injection of glycerine or a hypodermic exhibition 
of eserine. It is best to avoid too drastic or irritant purgatives 
as the cerebral congestion may be aggravated by the irritation, as 
it often is induced in severe indigestions. For the horse, aloes 
and podophyllin, or for ruminants, omnivora and carnivora 
castor oil may be resorted to. 

The patient must be placed by himself in a dark, cool, well 
aired building, and when able to resume feeding must receive an 
easily digeste4, non-stimulating diet ; for horses or cattle, gruels, 
wheat bran mashes, pulped roots, or green food ; for dogs and 
pigs, gruels, mush or milk. 

Any sequent paralysis must be treated on general principles. 



MENINGO— ENCEPHAI.ITIS. STAGGERS. 

Diviaoni. Causes : traumas, faulty diet, highly nitrogenous, leguminous 
seeds, undergoing ripening, cotton seed, gluten meal, forced feeding, buck- 
wheat, rye grass, lupins, cryptogams, trefoil, equisetum, narcotics, mi- 
crobian ferments, experiments with spoiled food and epizootics in wet 
years, high temperature, violent exercise, railroad travel, climatic change, 
complex causes, embolisms, infections, lead, phosphorus, tumors, parasites. 
Symptoms : with meningitis^ fever, hypersesthesia, active delirium and 
convulsions predominate ; with encephcUitis^ dullness, stupor, somnolence, 
muscular weakness, anaesthesia, paralysis, coma ; usually complex, hyper- 
thermia, periods of benumbing, followed by excitement ; drowsy, stupid, 
semi-closed e} el ids, drooping lips, ears, and head, latter resting on manger 
or wall, walks unsteadily, limbs out of plumb, hangs on halter, won't back, 
turns in circle, costive, indigestion, tympanies, rumbling, abnormal (often 
slow) pulse and breathing, congested optic disc ; alternate with trembling, 
excitement, pawing, rearing, plunging, pushing against the wall, trotting 
motions, etc. ; uncontrollable, violence ; severity and frequency of parox- 
ysms indicate gravity : recovery sequelse. Duration : death in 34 to 36 
hours ; or weeks. Prognosis : one quarter recover, with increased suscepti- 
bility ; nervous animals worst. Lesions : extravasation, congestion, exu- 
dates, pus, thickened meninges ; choroid plexus ; brain matter gray or red, 
puncta, infiltrated, softened, excess of leucocytes, red softening, yellow 
softening, sclerosis, cicatrix, abscess. Diagnosis : from rabies, cerebral 
congestion, immobility, influenza. Cattle, Symptoms : evidence of trauma, 
indigestion, lead poisoning, narcotism, parasitism ; dullness, stupor, somno- 
lence, stertor, grinding teeth, spasms, twitching, restless movements, blind- 
ness, violent actions, bellowing, hebetude, palsy. Relation to causation. 
Sheep: Symptoms. Swine: Symptoms. Dog: Symptoms. Diagnosis 
from rabies. Treatment : quiet, dai kness, coolness, restraint, ice or cold 
irrigation, elimination, derivation, depletion, diuretics, potassium iodide, 
antipyretics, laxative diet, cool water, evacuate abscess. Cattle^ similar, 
saline laxatives, for lead sulphuric acid, for coenurus, operation, for oestrus, 
benzine. Dog^ parallel treatment, milk diet or gruels, for lingnatula, 
benzine. 

The inflammatory affections in the cranial cavity have been 
divided primarily into the following : 

1. Meningitis. Inflammation of the coverings of the brain, and 

2. Encephalitis ( Cerebriiis). Inflammation of the nervous sub- 
stance. These are further subdivided into : 

A, Pachymeningitis, Inflammation of the dura Mater. 

B, Leptomeningitis, Inflammation of the pia Mater. 

94 



Meningo — Encephalitis. Staggers, 95 

C. Purulent Meningitis. 

D. Serous Meningitis. 

E. Tubercular Meningitis. 

F. Traumatic Meningitis, etc. 

G. Cef ebro' Spinal or Infective Meningitis. 
H. Acute Meningitis. 

/. Chronic Meningitis. 

J. Polioencephalitis Corticalis. InHammation of the brain cortex. 

K. Polioencephalitis Superior. Inflammation of convolutions 
around the Sylvian fissure, palsy of the eyeball. 

L. Polioencephalitis Superior. Inflammation of the Medulla, 
bulbar palsy. 

M. Interstitial Inflammation of the Brain. Resulting often in 
sclerosis. 

In the lower animals, however, where we cannot avail of sub- 
jective symptoms, such fine distinctions can rarely be made in 
diagnosis and except in case of an uncomplicated meningitis, or 
a circumscribed encephalitis, which affects only a limited group 
of muscles like those of the eye, arm, or leg, we have to fall 
back upon a more general diagnosis. Again meningo-encepha- 
litis is more common than the uncomplicated affection of the 
brain, or the membranes, and therefore, we shall follow Trasbot 
in dealing with the combined affection, and noting incidentally 
the distinctions that can be made in the more purely limited 
affections. 

Causes. Mechanical Injuries. Pachymeningitis occasion- 
ally results from blows or other injuries upon the head, especially 
in stallions and vicious horses struck with a heavy whip or club, 
cattle and sheep injured in fighting, and oxen hurt by the yoke. 
These injuries may also affect the brain as in concussion, or by 
the extension of the disease into the nervous tissue. In the 
cranium of a stallion in the New York State Veterinary College 
Museum the whole of the meninges are greatly thickened by a 
traumatic meningitis of old date and the subjacent cerebral con- 
volutions of the right hemisphere are deeply encroached on, flat- 
tened and absorbed over an area of i^ inches in the longest 
•diameter. 

Diet. Among the most common causes of encephalitis in 
horses is an injudicious dietary. Overfeeding with grain, but 



96 Veterinary Medicine. 

especially with grain and seeds that are rich in albuminoids 
deserve the first mention. The various leguminous seeds, peas, 
beans, tares, vetches, and the ripened leguminous fodders, clover, 
alfalfa and sainfoin, are especially to be incriminated. These 
are usually most dangerous when in the stage of advanced 
ripening and yet not fully matured, evidently indicating the 
development of narcotic poison at this stage. Such poisons are 
found habitually in certain species, like the chick vetch (vicia 
cicera) which produces paralysis when fed to the extent of more 
than one-twelfth part of the ration. This danger is not, how- 
ever, confined to the leguminosae ; an over abundant ration of 
cottonseed meal has a similar effect, and indeed this rich ali- 
mentary product has been practically discarded from pig feeding, 
and largely as the main constituent from the ration of dairy 
cows. Gluten meal, another product rich in proteids, is attended 
by similar dangers. But it is not alone the seeds that are rich in 
nitrogen that are to be dreaded, forced feeding even on the car- 
bonaceous maize induces disorder of the digestion and brain, 
especially in dairy cows. Buckwheat, also, and indeed all the 
heating carbonaceous grains tend to similar disorders, and are 
especially injurious in internal ophthalmia (recurring ophthal- 
mia) which is so closely related to brain congestion. With 
sound judgment and in well balanced rations, all such agents can 
be fed to advantage ; it is only when fed exclusively or to excess 
as the heavy ration that they are to be feared. 

Narcotics. Next must be noted those alimentary matters 
which are hurtful by reason of narcotic constituents. At the 
head of this list may be placed the lolium temulentum or intoxi- 
cating ryegrass. Like the vicia sativa or cicera, the seeds of this 
are always poisonous, hence its significant name. Then the 
other ryegrasses, perennial and annual (Italian), though per- 
fectly safe in ordinary circumstances, develop at the period of 
ripening a narcotic principle, which produces cerebral congestion 
or inflammation in whole stables of horses at a time. The lolium 
temulentum is poisonous to man and animals alike. Baillet and 
Filhol obtained from the seeds an etherial extract containing a 
bland oil to the amount of two-fifths and a yellow extract to the 
extent of three-fifths. The amount of this extract derived from 
three ounces of the seed often developed the most violent 



Meningo — Encephalitis, Staggers. 97 

symptoms in the dog, while that furnished by six pounds of the 
seeds proved fatal to the horse. Pigs and cattle seemed to be 
unaffected by the agent when given by the mouth. Sheep 
suffered more but required large doses. Ducks and chickens 
were practically immune, being affected only by very large doses. 
Rabbits were not poisoned by the yellow etherial extract, but 
succumbed to a watery extract. Brydon found that lambs 
suffered extensively from eating the heads of the ryegrass. 

Lupins on certain lands produces an icteric disorder ac- 
companied by cerebral symptoms but the result is not the same 
under all conditions and it has been suspected that the symptoms 
were caused by cryptogams and their products. The same re- 
mark applies to the brain symptoms sometimes produced by 
trefoil, equisetum and other plants. 

A great number of narcotic and narcotico-acrid plants pro- 
duce nervous symptoms indicating cerebral congestion or inflam- 
mation such as ranunculus, wild poppy, digitalis, fennel, cenanthe 
crocata, hellebore, veratrum, conium, yew, tobacco, box, aconite, 
cicuta virosa, even buckwheat at the time of flowering, vetch and 
flax. 

Fodders affected with cryptogams or bacterial ferments are 
undoubtedly at times the cause of encephalitis. Veterinary 
records furnish many instances of wide spread attacks of stomach 
staggers, abdominal vertigo, and cerebro-spinal meningitis in 
wet seasons, when the fodders have been harvested in poor con- 
dition, or when from inundation or accidental exposure they have 
becoine permeated by cr5rptogams and microbes. Among com- 
paratively recent accounts of this are those of Martin and Var- 
nell (musty oats), Irombroso, Depre, Erbe, Pellizi, and Tireli 
(smuts), Bouley and Barthelemy (musty fodder), and Ray 
(fermented potatoes). One of the most extended local out- 
breaks of cerebro-spinal congestion I have seen, occurred in the 
pit mules of the Wilkesbarre coal mines, while fed on Canadian 
hay which had been soaked with rain in transit and had under- 
gone extensive fermentation. It should be noted that there 
were the attendant factors of overwork, in anticipation of a strike, 
and a Sunday's holiday above ground in a bright summer 
sunshine. 

The experimental administration of moulds, smuts and mi- 
7 



98 Veterinary Medicine, 

crobes, have in the great majority of cases led to little or no 
evil result (Gamgee, Mayo, Dinwiddie, etc.) and there is a 
strong tendency to discredit the pathogenic action of these 
agents in reported outbreaks. The safer conclusion perhaps 
would be, to recognize the fact that they are not equally patho- 
genic under all conditions of their growth and administrati9n. 
The oft-recurring epizootics of brain disease in connection with 
wide spread spoiling of the fodders in remote and recent times, 
probably imply that cr5rptogams or microbes and their products, 
plus some condition not yet fully understood are efficient con- 
current factors. If we can discover this as yet unknown factor 
and demonstrate that it operates with equal power in the ab- 
sence of the cryptogams and ferments, as in their presence, it 
will be logical to pronounce these latter as nonpathogenic under 
all circumstances. Until then cr5rptogams and bacteria must be 
held as probable factors. 

A continuance of high temperature is an undoubted factor 
and becomes more potent, if conjoined with a close, damp, ill- 
aired stable. 

Violent exertion especially in hot weather produces active 
congestion of the brain and occasionally merges into meningo- 
encephalitis. If the animal has been for sometime confined to 
the stable on rich aliment the condition is aggravated. 

Railroad travel is another recognized cause. 

Any considerable change of the conditions of life may 
operate in the same way. A sale and transport to a distance 
with change of feed, water, work, stabling and even of cliinate 
is at times a potent factor. Prietsch has seen a horse attacked 
three times in a single year, and on each occasion after a change 
of ownership and locality. Trasbot quotes an Algerian veteri- 
narian to the effect that many of the Percheron horses imported 
into the Mitidja are attacked by encephalo- meningitis during 
the extreme heats of summer. 

A careful observation of cases will however show that in the 
majority of cases an attack comes not from one individual 
factor alone but from a concurrence of several operating together. 

Other cases are caused by embolisms and infections from 
diseases localized in other parts of the body. Thus we have 
cerebral abscess in pyaemia, strangles and omphalitis, and cerebral 



Meningo — Encephalitis. Staggers. 99 

congestions and inflammation in canine distemper, equine con- 
tagious pneumonia, laminitis, and angina. 

Among mineral poisons, lead is notorious as a cause of acute 
cerebral disorder often leading to inflammation. Other mineral 
poisons like arsenic and phosphorus may lead to encephalitis 
symptomatic of gastro intestinal irritation, or caused by the toxic 
products of indigestion. 

Rapidly growing tumors, like cholesteatomata, are liable to 
induce recurrent attacks of encephalitis in connection with 
periodic irritation. 

Finally parasites in the cranium are sufficient causes of at- 
tacks. In the New York State Veterinary College Museum is the 
brain of a cat with a nematoid wound round the h3rpophysis. In 
equine subjects suffering from the strongylus armatus the larval 
worm or dots caused by its presence in other arteries sometimes 
invade the encephalic blood vessels causing disturbances of the 
circulation, embolism, inflammation or degeneration. ( Albrecht, 
Von Heill;. The larvae of the cestrus has also been found in the 
bndn substance producing inflammatory or degenerative fod 
(Briickmtiller, Megnin, Siedamgrotzky). Thdr presence in the 
nasal sinuses at times causes encephalitis by oontig^ty. The ces- 
toid worms, CGenurus in sheep and other ruminants, and c>'sti- 
cercus in swine, find their natural larval habitat in the brain and 
by thdr movements produce more or less congestion and inflam- 
mation. Cases of ccenurus in the horse have been described by 
Rousset, Frenzd, Zundel, and Schwanefeldt. 

Symptoms. The symptoms of uncomplicated meningitis on the 
one hand and encephalitis on the other are rarely seen, the 
disease usually implicating more or less both brain and meninges, 
in a common inflammation or the s\-mptoms of the one invoh-ing 
those of the other through proximity or interdependence of func- 
tion. And yet in traumatic lesions of the cranial walls, the 
symptoms may be those of pure meningitis, and in thrombosis, 
embolism or parasitism of the brain, and in certain tumors they 
may be those of simple encephalitis. The distinction consists 
largely in the predominance of fever, h^-peraesthesia, active de- 
lirium and convulsions in meningitis, and especially in its earlier 
stages: and the prominence of dullness, stupor, somnolence, mus- 
cular weakness, paralysis, anaesthesia, coma, and the clouding of 
^ledal senses, with much less pronounced febrile reaction, or 
vascular exdtement in encepluditis. 



loo Veterinary Medicine, 

There is usually, however, a mixing of symptoms so that the 
benumbing or paralysis of the nervous functions alternates with 
periods of their exaltation, and with both conditions h3rperther- 
mia exists, though usually higher with meningitis. 

The manifestations of benumbing or paresis may be continu- 
ous or interrupted, and are exhibited in stupor, coma, somnolence, 
lethargy, paresis or paralysis. The manifestations of excitement 
are not continuous but occur in paroxysms or at least exacerba- 
tions, which may show in visual or mental illusions, active, vio- 
lent delirium, trembling, rigors, clonic or tonic spasms. The 
onset is usually abrupt, the animal passing in a few hours from 
apparent health, to pronounced nervous disorder. The horse 
seems drowsy and stupid, standing with semi-closed eyes, often 
drooping lower lip and ears, head pendent and resting in the 
manger or against the wall in front, the back arched and the 
limbs drawn together. When moved, it walks unsteadily and often 
the limbs are left out of plumb, one extending unduly forward, 
backward or to one side, and often crossing over its fellow. Some 
cannot be made to back, others back spontaneously hanging on 
the halter. Turning short in a circle is difficult or impossible 
and tends to throw the patient down. Yet some exceptional 
cases will turn around spontaneously to the right or left, and an 
animal tied to a post goes around it at the end of its halter in its 
effort to pass straight forward. The circling movement may be 
due to the irritation on the one side of the brain or to irritation of 
particular ganglia and nervous tracts as noticed under cerebral 
hyperaemia. 

Appetite is usually lost, or more properly, the animal no 
longer takes notice of surrounding things, not even of its food. 
In some cases, however, in which stupor or coma is not extreme 
the animal will eat a little during his quiescent intervals. In 
ryegrass and other dietetic poisoning, the animal may still eat and 
fall asleep with the mouth full. The digestion is impaired or 
suspended, the bowels costive, and fermentations with tympanies 
and rumbling are frequent complications. When originating from 
poisonous food this often contributes to these abdominal compli- 
cations. 

Respirations in the comatose condition are deep and slow, 
sometimes not more than four or five per minute. The heart 



Meningo — Encephalitis, Staggers, loi 

usually beats strongly, often tumultuosly, and the pulse varies 
greatly — ^infrequent or frequent, strong or weak, full or small. 
With cerebritis it is often abnormally slow. 

H)rperthermia is always present to a greater or less extent, 
being often more marked in the more violent forms or those in 
which meningitis appears to predominate than in the purely cere- 
bral forms. The temperature may vary from ioi° to io6°. 

The optic disc is congested. 

Probably in all cases or nearly all there is a preliminary stage 
of excitement, in which the eye is clear, the eyelids open, the 
aspect alert and the whole skin affected by a marked h)rper- 
sesthesia. In some cases the symptoms of excitement are much 
more violent at the outset of the disease, as marked by trembling, 
nervous movements, pawing, pushing the head against the wall 
while the motions of walking or trotting are performed by the 
limbs, ot those of plunging forward, rearing up, drawing back 
on the halter, etc. 

But even when the disease seems to have started with stupor 
and coma, these paroxysms of excitement almost invaribly ap- 
pear at intervals as it advances. Some, however, plunged in 
stupor or coma at the first, remain in this condition until they 
end in paralysis or death, or start in convalescence. 

During one of the paroxysms the trembling animal may push 
his head against the wall as if pulling a heavy load ; at other 
times he will plunge with his feet in the manger and recoiling, 
fall to the ground, where he struggles violently in an apparent ef- 
fort to rise ; others rear up, pulling on the halter or breaking it 
and falling back over ; some pull back on the halter and throw 
themselves down ; some grind the teeth, or seize the manger, or 
strike blindly with the fore limbs. When seized out of doors 
the horse may be quite uncontrollable and refuse to return to the 
stable even when led by two men with double halters. In all 
such cases the eye has a fixed, glaring aspect which is the more 
pronounced when the pupils are dilated, the conjunctiva is 
deeply congested, of a deep, brownish red with a tinge of yellow. 
This is usually greatly enhanced by the bruises and extravasa- 
tions caused by pushing or knocking the head against the wall. 
The same violence may lead to serious bruises and injuries else- 
where, even fractures of the orbital process or zigoma, of the 



I02 Veterinary Medicine, 

ilium or ischium, of the poll or the base of the brain ; also of the 
incisor teeth. 

These paroxysms may be so frequent that they seem to be sub- 
ject to remissions only, and not separated by complete intermis- 
sions. During the paroxysms breathing and pulsations are both 
greatly accelerated. 

The gravity of the attack may be judged in part by the vio- 
lence and frequency of the paroxysms. Yet some cases, marked 
by profound coma from the first, prove the most rapidly fatal, 
and the paroxysms of excitement and violence are not incompat- 
ible with recovery. Improvement may usually be recognized by 
the increased length of the intervals between the paroxysms, and 
by the shortening and moderation of the periods of excitement. 
After the paroxysms have ceased the drowsiness or stupor gradu- 
ally disappears, and the hyperthermia subsides. 

Even after recovery from the acute or violent symptoms there 
is liable to remain some aberration or perversion of function, due 
to the persistence of some encephalic or meningeal lesion. The 
general hebetude known as immobility may bespeak dropsy of 
the ventricles, pressure of a tumor or clot, or degeneration of 
ganglonic centres. Diseases of the eyes (amaurosis, glaucoma, 
cataract), or of the ear (deafness, disease of the internal or 
middle ear) are less frequent results. 

The supervention of general or facial paralysis or of hemi- 
plegia during the active progress of the malady, is an extremely 
unfavorable symtom. 

Duration, A fatal result may take place at any time by self 
inflicted injuries (dashing the head against the wall, or falling 
backward and striking the head on a solid body). Apart from 
this, death may come within twenty- four or thirty-six hours. If 
the animal survives two to seven days recovery is more probable. 
Hering records a case of recovery after five weeks illness. Hot 
weather hastens a fatal result, while cool, cloudy weather is 
favorable. 

Prognosis, Under rational treatment about one-fourth recover. 
One-half of the victims make a partial recovery but remain in a 
condition of dementia or hebetude, blindness, deafness, local or 
general paralysis which renders them more or less useless. Not 
more than one-fifth or at most one-fourth of all cases recover. 



Meningo — Encephalitis, Staggers. loj 

Even in these there is left an increased predisposition to re- 
currence. It is noted by Trasbot that the mortality is higher in 
highbred, nervous, irritable animals, which show a tendency 
to greater frequency, force and duration of the paroxysms of ex- 
citement. When decubitus is constant, death may take place 
from septic poisoning starting from bed sores, and gangrenous 
sloughing. In other cases there is fatal starvation from inability 
to eat. 

Lesions. In pachymeningitis due to mechanical injury there 
is usually cutaneous and subcutaneous, blood extravasation, and 
there may be fracture of the cranial bones. The dura matter is 
dark red, hyperaemic, thickened, covered with exudation and small 
blood clots mixed with pus cells, and has contracted strong ad- 
hesions to the cranial bone. Bony spicula may project into the 
fibrous neoplasm. 

Leptomeningitis usually coexists from extension of the in- 
flammation into the adjacent arachnoid and pia mater. There 
is then a reddish serous effusion into the arachnoid and beneath 
it, and the substance of both membranes is thickened by exudate, 
and discolored by congestion and minute haemorrhages. When- 
ever the pia mater is thus inflamed, the superficial layer of the 
brain is implicated, oedematous, soft and doughy. The exten- 
sion is also made into the ventricles and a serous effusion takes 
place often to two, three or more times the normal amount 
(82 grammes, Schiitz). The choroid plexus forms a yellowish 
gelatinoid mass, and the ganglia (corpora striata, optic thalamus, 
etc.), are flattened. 

In encephalitis the affected superficial gray matter of the 
ganglia or convolutions, is deepened in color, usually in limited 
areas corresponding to the disease of the meninges. Sometimes 
the color becomes of a distinctly reddish tinge, and, when cut into, 
shows unusually prominent red points where the capillaries have 
been cut. Somewhat larger areas of blood staining indicate haemor- 
rhagic extravasations. The nervous substance is more or less 
infiltrated with liquid and softened. The nerve cells are swollen, 
and in process of granular degeneration and the same is true of 
the myelin, while the axis cylinder is uneven in its outline. 
Apart from the numerous minute petechial haemorrhages there is 
an abundant migration of leucocytes which are found scattered in 
the degenerating and softened nervous tissues. 



I04 Veterinary Medicine, 

The softening of the nervous tissue may result in a pulpy 
material, which in the comparative absence of blood is grayish 
(gray softening), if abundantly infiltrated with blood is red 
(red softening), if older and discolored is yellow, as in an old 
extravasation (yellow softening), if thick and viscous is gc- 
latinoid softening. If the exudate becomes organized into 
fibrous material it is a connective tissue sclerosis or a cica- 
trix. If the softening exudate becomes purulent it constitutes 
a cerebral abscess. Cerebral abscess is especially common as 
secondary abscess in strangles or contagious rhino-adenitis in the 
horse, but may occur as the result of the presence of any pyo- 
genic germ. 

Diagnosis, 'While there is a certain similarity to rabies, the 
horse with encephalo-meningitis is distinguished by the absence 
of the extreme h3rperaesthesia and irritability, of the persistent 
neighing and squealing,, of the rapid alterations of the voice, 
hoarse and shrill, of the hallucinations, as following imaginary 
objects with the eyes, of the readiness to attack with teeth or 
heels when in any way disturbed or excited, of the disposition to 
get violently excited when a dog is brought near, or in the case 
of a stallion to show generative excitement. 

From cerebral congestion it is to be distinguished by the 
greater severity of the paroxysms, or the deeper character of the 
stupor, but above all by the presence of the hyperthermia and 
other indications of fever. 

Immobility which presents the symptoms of drowsiness, 
stupor and hebetude, is also unattended by fever, or anorexia, 
shows a healthy condition of the functions of respiration, diges- 
tion and assimilation and a restful condition when left quiet 
and .still. 

The cerebral excitement that sometimes appears in influenza is 
really an encephalitis complication, but its specific cause is 
recognized in the local prevalence of the infectious disorder, and 
the inflammatory or catarrhal condition of the mucous membranes. 

The diagnostic manifestations of meningitis and encephalitis 
respectively are given under symptoms. 

Symptoms in Cattle. In cattle encephalo-meningitis super- 
venes on congestion, and sometimes comes on abruptly in con- 
nection with traumatic injuries, acute gastric disorder, lead- 



Meningo — Encephalitis, Staggers. 105 

poisoning, or narcotism. The cases of cerebral parasitism are 
usually slow in their onset. 

Upon the preliminary dullness and somnolence there super- 
venes excitement, manifested by loud bellowing, pushing the 
horns, forehead or teeth against the wall, labored often stertorous 
breathing, a fixed eye often with dilated pupil giving it a peculiar 
glaring appearance, movements of the jaws, frothing at the lips, 
tremors, muscular spasms, twitching, or a restless disposition to 
move, in a circle, in a straight line or less frequently backward. 
The patient seems to see nothing and is utterly regardless of ob- 
stacles. Sometimes the animal plunges violently into manger 
or rack, against or through the partition of his box, through 
fences, into ponds, pits, quarries and other dangerous places that 
may be accidentally in his way. The paroxysms may be inter- 
mitted by intervals of comparative calm, and tend to merge into 
a condition of dulled sensation, staggering, stupor, hebetude and 
paralysis. The congested conjunctiva and, when it can be seen, 
the optic disc will correspond to the cerebral congestion. These 
cases usually proceed to a fatal issue in a few hours. Some 
cases, however, make a good recovery after a few days of dull- 
ness and prostration. In cases that are connected with lead 
poisoning, or the toxic action of narcotics in the fodder, the at- 
tendant circumstances will assist in the diagnosis. From malig- 
nant catarrh implicating the encephalon, it may be distinguished 
by the absence of the catarrhal inflammation of the conjunctiva, 
pituita, sinuses, buccal mucous membrane, and genito-urinary 
passages. Also of the tendency to implication of the hair follicles 
and the keratogenous tissue of the frontal horns. 

In the Edinburgh Veterinary Review^ Dundas describes a form 
of alcoholism in cows caused by feeding these animals on '* burnt 
ales*' in the vicinity of distilleries. The ale is given by steeping 
straw in it, and the animals will also drink it freely. They often 
sleep soundly after such a beverage or give evidence of intoxica- 
tion. The head is turned singularly to one side and slightly ele- 
vated. The pupils are widely dilated, and the eyes have a re- 
markably wild appearance. On being approached the animals 
wink rapidly and tremble. There is marked heat of head, horns, 
and ears. When pressed with the finger in the axilla they fall 
instantly and when pulled by the head they incline to turn over. 



io6 Veterinary Medicine. 

The pulse is 70 to 80 per minute. Delirium and loss of coordi- 
nation of the muscular movements set in, and in case of survival 
various forms of chronic brain disease are manifested. In one 
cow the violent symptoms came on with the near approach of 
parturition. The post mortem lesions consisted in ramified red- 
ness and punctiform blood extravasations in the pia mater and 
meninges. The brain substance was softened and clots of blood 
were found in the lateral ventricles. Congestion and extravasa- 
tions were also found around the cervical myelon. (See Alco- 
holic Intoxication.) 

Symptoms in Sheep, The sheep is often drowsy, dull and 
stupid, lying by itself with head low or laid backward. During^ 
the periods of excitement it works the jaws, froths at the mouth, 
carries the head turned in one direction, upward or lateral^ 
bleats . piteously, pushes against the wall, has uncertain, 
stiff or staggering gait, or convulsions, and finally paralysis. 
The head is hot, and the eye fixed, congested or sometimes 
rolled upward or squinted. Symptoms in the goat are nearly 
the same. The coenurus disease is more gradual in its onset, 
and produces periodic paroxysms corresponding to the activity 
of the heads of the parasite when protruded into the brain 
substance. It is mainly confined to sheep of one year and 
under and that are kept where dogs have access. 

Symptoms in Swine, Pigs may at first have a period of dull- 
ness or restlessness, the latter merging into active delirium. The 
patient champs his jaws,* froths at the mouth and nose, some- 
times vomits, squeals, raises himself with fore feet on the wall, 
walks round and round, or falls and rolls over, has tremors or 
convulsions. 

Symptoms in the Dog, There may be preliminary indications 
of illness, anxiety, restlessness, irritability and a desire for seclu- 
sion. Vomiting may occur. This is liable to merge into pros- 
tration, a dullness of the special senses, utter inattention to calls, 
yet a disposition to resent any interference, a readiness to bite, at 
least to howl, when handled. Some will constantly howl or 
moan. The eye is fixed, the pupils dilated, the conjunctiva deep 
red, the head and roots of the ear are hot. The expression of 
the face is pinched and drawn, the muscles may twitch, the eyes 
roll, twitching of the neck or limbs may appear, and even epilep- 



Meningo — Encephalitis, Staggers, ' 107 

tiform attacks. In exceptional cases the symptoms approximate 
to those of rabies, in. the tendency to seek seclusion, to wander 
ofF, to bite on any interference, and even to gnaw the bars of the 
cage or any object within reach. After more or less of such ex- 
citement, the period of stupor, coma, paresis, or paralysis comes 
on, and the animal dies in a state of complete nervous prostra. 
tion. In cases associated with the linguatula taenioides the 
sneezing, nasal discharge and nasal congestion, even in the early 
stages, betray the true character of the disorder. 

The rabiform cases usually lack the intense irritability, the 
deep conjunctival congestion, the depraved appetite, the al- 
teration of the voice, and the mischievous desire to attack 
without reason which characterize rabies. 

Treatment, In all cases of phrenitis, quiet, darkness, and 
coolness are especially demanded. For the horse a roomy, loose 
box or a well fenced yard may be secured, and if he can be se- 
cured by a halter from a point above the level of the head and in 
the centre of the box it will obviate the increase of congestion by 
hanging of the head. The application of cold to the cranium in 
the form of wet cloths, ice bags or irrigation is always in order, 
and should be continued so long as heat of the head and other 
indications of cranial h3rperaemia last. 

In the horse suffering, as is so often the case, from narcotic 
poisoning an active purgative is one of the first considerations to 
clear away any remains of the poison from the prima viee. An 
ounce of aloes may be safely given, as there is in this case little 
danger of superpurgation, and, to secure an even more prompt 
response, eserine ( i j4 grain) or barium chloride (^ drachm) may 
be given subcutem or intravanously. Or an ounce or two of 
glycerine by the rectum might be used as a substitute for these 
last. The action of the purgative proves not only eliminant and 
therefore antidotal, but it is a most eflFective derivative from the 
brain. When the restlessness or excitement is very great we 
may use acetanilid, trional, sulphonal or some one of the many 
brain sedatives and antithermics. Sedatives, or anodynes like 
opium, which tend to increase cerebral congestion are dangerous. 

Bleeding from the jugular or temporal artery, has been objected 
to ou the ground that it tends to increase the exudate and there- 
fore the pressure and cerebral anaemia. On the other hand it 



io8 Veterinary Medicine, 

often proves of great value in vigorous, muscular and plethoric 
horses in temporarily lessening the blood-pressure in the brain, 
and afiFording the walls of the overcharged capillaries an oppor- 
tunity to resume a more normal tone and to control that very 
exudation which is so much dreaded. It is most efiPective in the 
early stages when little or no exudation has taken place and may 
then be pushed to the extent of producing a perceptible softening 
of the pulse (4, 6 or 8 quarts). Even in the advanced stages 
when exudation has led to stupor or coma a moderate and care- 
fully guarded bleeding may favor reabsorption of the liquid exu- 
date. In weak and ansemic cases in which general bleeding ap- 
pears to be contra-indicated the shaving of the cranial surface 
followed by leeching or wet cupping can be safely resorted to. 

Counterirritants like bleeding are denounced and advocated by 
diflEerent practitioners. In cases of extreme h3rperaesthesia where 
excitement and fever would be dangerously increased by their 
use, they must be discarded, or used only in the modified form 
of soothing hot fomentations to the extremities. Where there 
is less sensitiveness mustard poultices or pulp applied on the sides 
of the neck, or upon the limbs, or even more energetic blisters 
will be of great service. 

After the action of the purgative the bowels may be kept free 
by calomel in yi drachm doses twice daily and as much sulphate 
of soda as may be necessary. 

Iodide of potassium ( 1-2 drs. twice a day) is beneficial as 
an antithermic, a circulatory sedative, an eliminant, and probably 
at times as an antidote but it cannot be given while calomel is 
used. Certain it is that it often seems to act well in succession 
to the purgative, in cases of poisoning by ryegrass and legu- 
minosae. 

When fever runs very high it may sometimes be admissible 
to give aconite, but the coal tar products are much more prompt 
and powerful, and may therefore be more hopefully employed 
for a short time. 

In conditions of extreme prostration, stupor, or coma, stimu- 
lants are resorted to, but too often with no good effect, the 
exudation and compression which many times cause such symp- 
toms being rather aggravated than benefited by such agents. 

During convalescence a restricted, non-stimulating laxative 



Meninga — Encephalitis, Staggers 109 

diet (bran mashes, gruels, apples, potatoes, carrots) is de- 
manded. Pure cool water should be always accessible. 

In other forms of meningo-encephalitis the same general prin- 
ciples should be applied, due attention being paid to the re- 
moval of the active cause when that can be discovered. 

When the indications point unequivocally to abscess, and its seat 
can be accurately located by a circumscribed paralysis, an 
operation for its evacuation is fully warranted. Otherwise death 
or permanent uselessness is almost certain. 

In cattle and other ruminants the same general principles of 
treatment must be applied. As a cathartic Epsom or Glauber 
salts are preferred to aloes and may be supplemented by barium 
chloride or eserine. Croton, sometimes useful, is liable to 
dangerously increase the gastric irritation in cases in which this 
is a marked determitiing factor. When the animal is down, 
raise the head by bundles of straw, or by a halter tied to a 
beam overhead. In lead poisoning, sulphuric acid largely diluted 
may be added to the sulphates so as to precipitate the insoluble 
sulphate of lead. Potassium iodide is of value to dissolve the 
lead in the tissues and lead to its elimination. Cases of coenurus 
require trephining and extraction ; the larvae of the oestrus should 
be washed out with tobacco water or destroyed by benzine. 

In dogs the stomach is usually emptied spontaneously by 
emesis. A purgative of castor oil, followed by daily doses of 
calomel may be given, and attention given to the cooling of the 
head and general system. Antipyrin or acetanilid may be use- 
fully employed. The diet should be restricted to milk or thin, 
well-boiled gruels. 

The linguatula in the nose must be met as are the oestridae of 
the sheep, and intestinal worms must be got rid of by active 
vermifuges. 



CHRONIC HYDROCEPHALUS. DROPSY OF THE VEN- 
TRICLES. IMMOBILITY. 

Horse especially suffers. Enzootic in ji^ven Alpine Valleys, along Rhone, 
in Miwissippi Valley and bottom lands. Acclimatizing fever. Old, 
lymphatic, large heads, narrow foreheads predisposed. Geldings. Causes, 
heredity, cerebral and meningeal congestion, cranial traumas, venous ob- 
struction, tumors, false membranes, fodder or water poisoning, overwork, 
insolation, prolonged moist heat, hepatic, gastric, and pulmonary disorders 
Symptoms: form of head, stupid expression, irresponsive ears, pendent 
lips, sluggish movements, crossed legs, slow mastication, dips face in water, 
intractable by halter or rein, unable to back with rider, or wagon, drags 
back fore limbs, worst in hot damp wtather, in sunshine, or after work, or 
with full stomach. Paroxysms of excitement. Lesi >ns : excess of arach- 
noid, subarachnoid or ventricular fluid, atrophy of ganglia and convolu- 
tions, ependyma thick, opaque, sclerosis, brain ansemic. Tumors, nature. 
Kxperimental cases Prognosis, incurable, better in cool season. In cattle, 
sheep, swine and dogs. Treatment: derivatives, nerve stimulants (nux), 
puncture, pilocarpin, purgatives. Jurisprudence. Notify seller in 9 days 
(France), 15 (Bavaria), 21 (Wurtenberg, Baden), 28 (Hesse, Prussia), 30 
(Aufttria). Examination by expert. 

Dropsy of the ventricles is common in the horse in certain 
countries and districts, yet even there it is uncommon in cattle, 
sheep, swine and dogs, save as a congenital affection. It is re- 
ported as enzootic in some Alpine valleys and along the Rhone, 
attacking especially the mares and immature horses so that breed- 
ing becomes impossible. Mauener who reports this says that in 
the same localities encephalic diseases are more common in man. 
In America it appears to be most frequent in the rich bottom 
lands of the Mississippi valley and of the Southern States. 
Northern horses taken to the Gulf States though they may not 
suffer to this extent, are liable in the first year to show weakness, 
debility, and lack of vigor which is spoken of as the acclima- 
tizing fever. Elsewhere the affection is one of the old horses in 
which the vital powers begin to fail. Common breeds of horses 
with lymphatic temperament, large head and narrow forehead 
have been found to be especially predisposed. Geldings are said 
to be most liable on account of the arrested development of the 
brain, but with the great preponderance of geldings among work 
horses, it is dangerous to generalize too far. 
no 



Chronic Hydrocephalus, Dropsy of the Ventricles. 1 1 1 

Causes. Acute encephalitis may lapse into the chronic form and 
then assume the symptoms of this disease. Cases that come on 
slowly and imperceptibly appear at times to be hereditary, as 
might be expected from the fact that it usually goes with a 
lymphatic temperament. The conditions which cause cerebral or 
meningeal hyperaemia in chronic form conduce to the affection. 
Injuries to the cranial vault from traumatism or disease are infre- 
quent causes. Renault records a case associated with two bony tu- 
mors, each as large as an egg, projecting inward from the frontal 
bone and which had produced extensive absorption of the convolu- 
tions and increase of the cerebro spinal fluid. In a case of my 
own with an abscess in the diploe above the frontal sinus, and 
pressing inward on the brain a similar condition existed. In 
other cases Renault noticed that the cerebro spinal fluid was 
largely in excess. 

Much more commonly, however, the accummulation of liquid 
takes place in the ventricles, and is associated with different 
causes : as tumors or false membranes near the base of the brain 
pressing on the veins returning blood from the ependyma, tumors 
in the ventricles (cholesteatomata, etc., of the ependyma or 
<!horoid plexus) obstructing the circulation or giving rise to local 
hyperaemia, and chronic congestions from the other causes such 
as faulty conditions of fodders, or water, exposure to undue heat, 
overwork, etc. The enzootic prevalence of the disease in certain 
localities, (Alps, Rhone Valley, bottom lands) would suggest that 
local conditions in food or water are factors, though we cannot as 
yet fully explain the mode of causation. In the same way we 
must recognize the influence of hepatic and gastric disorders 
which arise from such faulty regimen and affect the brain by 
nervous sympathy and by the action of toxic elements thrown 
into the circulation. Then again we must take sufficient ac- 
count of the congestions resulting from obstructions in the 
lesser circulation, disease of the lungs, and of the right heart, 
and compression of the jugulars by a tight or badly fitting 
collar, or compulsory curving of the neck as set forth under 
vertigo and cerebral congestion. 

Symptoms. Among the symptoms must be recognized the 
conformation with which it is usually found associated. The 
predisposed animals are usually low bred, common horses, with 



112 Veterinary Medicine, 

narrowness of the cranium and space between the ears and 
with a retreating of the head from the orbits to the poll. Other 
horses suffer but the majority are of this conformation, and thus 
the disease acquires a hereditary basis. 

The expression of the face is characteristic. The eye is dull, 
often sunken, lacking in vivacity and life, the eyelids are 
semi-closed, the ears do not prick up to sounds, the muscles of 
the face are relaxed, so that the lips hang flaccid, and the nostrils 
fail to dilate freely and rhythmically. The animal is apparently 
unconscious of all that goes on around him, and is not aroused 
by the entry or exit of men or horses, by voice or slap, by 
food or water. His head is probably dropped and resting in 
the manger, and he raises it sluggishly when compelled ; when 
moved from side to side cf the stall his legs may retain a 
position turned outward or crossed one over the other ; if ener- 
getically roused he wakes up slowly, and almost immediately 
relapses into his former lethargy, without accomplishing what 
was called for. When left with legs crossed he often remains so 
until wearied by the constrained position, or in danger of falling 
from loss of balance. Not only the legs but the head will re- 
tain for a time an abnormal position given to it, — ^bent, dropped, 
turned to one side or the other. 

This same lethargy extends even to mastication, which is usu- 
ally performed slowly and indifferently, and is often interrupted 
in the middle of the trituration of a morsel which remains in the 
cheek, on the tongue, or between the teeth, and perhaps hanging 
out of the mouth. Hence the horseman's expression, he smokes 
his pipe. 

His mode of drinking is no less singular. Usually the lower 
part of the face is dropped deeply into the water, and he will only 
withdraw it when it becomes necessary to breathe. He may con- 
tinue to masticate while drinking. 

When walked or trotted he may move a short distance all right ; 
he may even hasten his progress for a short distance without 
refusing meanwhile to respond to the rein, then he may stop 
and for a short time longer resist all efforts with voice, whip, or 
spur to start him anew. In other cases he will turn to one side, 
getting into ditches or fences by an apparently involuntary action 
and in defiance of whip or reins. 



Chronic Hydrocephalus, Dropsy of the Ventricles, 113 

One of the most striking features of the disorder is the difficulty 
of backing. In some cases he will back a few steps and then prove 
unable to back farther ; in others he will show it best when heat- 
ed with a jonmey ; in other cases still he will back well enough 
under his own weight, but prove utterly unequal to the act if a 
heavy man is placed on his back, or if hitched to a loaded wagon. 
In backing with or without a rider the horse, pulled back by the 
reins, inclines backward with his hind limbs extended forward 
beneath the abdomen, his forefeet extended in front, and his back 
arched ; he extends his head or turns it to one side, and when the 
change in the center of gravity endangers his equilibrium, he 
draws back his forefeet without lifting them, each making a 
groove in the ground, and at the same time he makes a disorderly 
motion of the hind limbs to one side to restore the balance. In 
default of this he may drop his quarter on the ground and perform 
a back somersault on his rider. Even when he succeeds in bal- 
ancing himself after dragging the forefeet back, the difficulty of 
further backing is rather increasied, as the nervous irritability is 
enhanced by a continuance of the excitement. 

When hitched in a carriage the phenomena are virtually the 
same ; when backed he extends or flexes the head, inclines the 
body backward, and after a time loses his equilibrium, sometimes 
executes a few disorderly steps backward, or throws himself vio- 
lently tp one side, or turns over backward in the shafts. 

The symptoms are always worse during hot, damp weather, and 
when the animals are exposed to the full glare of the sun. The 
milder cases can be worked without great inconvenience in winter, 
while they become utterly useless in summer. 

Active exertion and increased rapidity of the circulation has a 
similarly injurious effect. After a period of rest nothing amiss 
may be noticed, while after a period of work in the sunshine the 
symptoms become well marked and the difficulty of backing pro- 
nounced. Plethora or full feeding aggravates, while spare, laxa- 
tive diet, laxatives, rest or bleeding relieves. 

The affection may become complicated by more active inflam- 
matory action leading to paroxysms resembling those of meningo- 
encephalitis ; — pushing against the wall, rearing up with the fore 
feet in the manger, acting as if walking or trotting, etc. In 
other cases the paroxysms resemble those of vertigo ; the animal 
8 



1 1 4 Veterinary Medicine, 

plunging forward, starting to one side, or rearing up and falling 
back. 

Lesions, The pathological anatomy of this disease is that of 
chronic hydrocephalus. Renault records cases in which the sub- 
arachnoid and arachnoid fluids were under the normal while the 
fluid in the ventricles was increased to a marked extent. This 
accumulation is often so great that the whole of the surrounding 
nervous matter is greatly attenuated, the convolutions of the 
cerebral hemispheres are flattened so that the sulci are all but ef- 
faced, the water may shine through at points and even bulge 
after the manner of a hernia, the ganglia in the ventricle (corpus 
striatum, optic thalamus, hippocampus) are flattened and atro- 
phied, the base of the cerebrum is thinned and bulges downward, 
and the olfactory lobes may have their internal cavity greatly 
distended so that they look like little bladders of fluid. The 
ependyma may have lost its normal thinness and translucency, 
having become thick and opaque, and sometimes its surface is 
granular and rough. The choride plexus is congested and 
swollen with infiltration. The brain tissue adjacent is firmly ad- 
herent and there is a h5^rplasia of its connective tissue consti- 
tuting a veritable sclerosis. At some points, however, the com- 
pressed nervous tissue has undergone degeneration and softening. 
As might be expected from the pressure of the liquid, anaemia of 
the brain tissue is a marked feature of the morbid condition. 

Other conditions have at times been found in chronic hydro- 
cephalus. 

Renault found two long tumors each as large as a hen's egg 
projecting from the dura mater into the cerebral hemisphere. In 
other cases there have been fibrous thickening of the dura mater, 
exudations on the pia mater, and false membranes on the arach- 
noid (Roll). Chabert and more recent writers have observed 
cysts and tumors of the choroid plexus in such cases, but these 
have been met with not unf requently in the entire absence of the 
characteristic symptoms of this disease. 

Nature, The affection before us is evidently one in which the 
majority of the higher brain functions are profoundly depressed 
or debilitated, and this is accounted for by the accumulating 
intraventricular liquid pressing on the ganglionic centres in the 
cerebral hemispheres, and in the floor of the lateral and third 
ventricles. 



Chronic Hydrocephalus, Dropsy of the Vetitricles. 115 

Bxperimentally an approximate loss of sensation, intelligence, 
spontaniety, will, and muscular power is produced in birds or 
mammals deprived of their cerebral hemispheres. Colin*s heifer, 
which had been thus mutilated, would lie in torpor, and though 
it could be made to get up and walk, it struck its head heedlessly 
against the wall, and retained in its mouth unchewed, the food 
that had been placed there. He says of such cases : * * they live 
a long time, move automatically, respire, digest, but they lose, 
with the sensations, memory, judgment, will, and the most vital 
instincts of their kind.'* 

In the dropsy of the ventricles the attenuation and atrophy of 
the cerebral convolutions produce symptoms which approximate 
closely to those resulting from their experimental ablation, so 
that one may fairly attribute the general symptoms in the two 
cases to the loss of their function. Many of the attendant symp- 
toms, and especially the aberration of smell, sight, hearing and 
taste, may be referred to the concomitant injuries of the basal 
ganglia of the brain. 

We need not seek in one general answer to resolve the question 
whether the dropsy or inflammation is the initial lesion. For our 
present purpose it must suffice, that the dropsy with anaemia and 
atrophy of the cerebral convolutions and basal ganglia produce 
the symptoms of immobility. 

At the same time it is only logical to conclude that any morbid 
condition of the cerebral circulation or of the brain or membranes 
which leads to a corresponding amount of ventricular effusion, or 
atrophy or destruction of the nerve centres, already designated, 
will produce the symptoms characteristic of this disease. Thus 
the diflFerent forms of meningitis, traumatic injuries to the 
cranium, chronic encephalitis, cerebral softening or degeneration, 
sclerosis, neoplasms of all kinds affecting the brain, (cysts, choles- 
teatoma, psammoma, melanoma, etc.), and parasites may occasion 
this disease. 

Prognosis, The disease is essentially incurable. It may last 
for years with little change except the winter improvement, but it 
rarely subsides permanently. It is only in those cases in which 
the symptoms have been determined by a transient or removable 
cause, as a moderate exudation or a parasite with a short term of 
life that a favorable result may be looked for. Usually the im- 



1 1 6 Veterinary Medicine, 

provements seen in cool seasons or stables, under good hygiene, 
are not recoveries but temporary, amelioration only. 

Symptoms in other animals. Corresponding conditions produce 
similar symptoms in cattle, sheep, swine and dogs, but the disease 
receives less attention in these animals because they are not called 
on for steady work. The animals are lazy, dull, insensible to 
excitement, stupid, show a lack of muscular power and control, 
stagger or move disorderly and show tympanies or other indica- 
tions of indigestion. 

Treatment, Majendie and others had a few apparent recoveries 
after violent counter-irritation over the spinal cord (cervical and 
dorsal). Coculet and Lafosse claimed recoveries from the pro- 
longed use of nux vomica in large doses (up to 5 drachms). 
Hayne attempted evacuation of the fluid by puncture through the 
perforated plate of the ethmoid bone, but had evil results from 
the ensuing haemorrhage and encephalitis. Aseptic puncture 
through the plate of the frontal bone would be much more prom- 
ising. Klemm suggested hydrochlorate of pilocarpin (15 grains) , 
and this would promise better than any other measure to induce 
absorption of the liquid. The fatal drawback to this as to other 
measures is that it is not applied until the slow, steady pressure 
has caused such extensive cerebral atrophy that, even if the liquid 
could be removed and its reproduction prevented, the lost func- 
tions can never be restored. If the disease could be diagnosed 
and treated before this change of structure had taken place, the 
hope of recovery would be much better founded. Even in cases 
which make a temporary recovery during cold weather one would 
be warranted in using active derivatives toward the bowels and 
kidneys, also pilocarpin, counter-irritation to the spine and even 
tapping of the ventricles. 

Legal Aspect of Chronic Hydrocephalus. 

To claim relief in case a horse afiFected in this way is sold as 
sound, the seller mftst be notified at an early date. InthediflFer- 
ent countries of Europe a limit is set after which such notification 
will have no legal value. The seller must be notified, in France 
in 9 days, in Saxony in 15 days, in Bavaria, Wurtenberg and 
Baden in 21 days, in Hesse and Prussia in 28 days, and in Austria 
in 30 days. 



Chronic Hydrocephalus. Dropsy of the Ventricles. 117 

Diagnosis. The veterinarian called to act as expert in such 
cases must examine the suspected animal along the different lines 
in which the cerebral aberration is manifested in the disease. He 
will see the animal standing quietly in the stall apart from all 
sources of excitement. See if there is a defect in the breadth of 
the cranium, or a deflection backward of this region from the 
straight line of the front of the face, together with a heavy clumsy 
head. Is the head pendent, resting on the manger, with dull eye, 
drooping lids, lack of expression, loose hanging lower lip? Does 
he hold morsels unchewed projecting from the mouth or over the 
tongue, or in the cheek ? Does he plunge both mouth and nose 
in the water to drink, and masticate meanwhile ? Are his legs 
found crossed or in abnormal positions, and if put in such posi- 
tions, does he fail to rectify them at once ? Is the head left in an 
abnormal flexed, depressed or lateral position if placed in it ? 
Does the subject find it difficult or impossible to back ? Does he 
pay the customary attention to the going or coming of other 
horses, to feeding, etc. ? 

If no distinct s3rmptoms are found he should then be examined 
under other conditions. In taking out of the stable how does he 
turn in the stall or back out of it, and in what way does he 
approach the door, clumsily or with difficulty ? When moved in 
a circle, does he sway or stagger ? Can he back when mounted 
or attached to a heavy carriage ? Can he execute all these move- 
ments satisfactorily after the respiration and circulation have been 
excited by walking, trotting or galloping in hand or otherwise? 
In case of difficulty in backing, in the absence of the other diag- 
nostic symptoms, he must see that this does not arise from other 
causes. Some untrained horses have not been taught to back and 
cannot be made to do so at once. Some refuse to back from in- 
docility or stubbornness, but can perform the act if induced in 
other ways, as in having a narrow stall. Sometimes a sore mouth, 
from a hard bit may make a horse nervous and obstinate so that 
he will seek to escape in any other way rather than by backing 
under steady pressure of the bit. Sometimes he will back all 
right under the halter. In all such cases of simple obstinacy or 
fear of jKun, the absence of the other symptoms is strongly sug- 
gestive. If the horse has a well developed cranium, a full bright, 
alert eye, firmness of lips, intelligent expression, readiness to 



Ji8 Veterinary Medicine, 

appreciate and respond to all noises, words, touches or other 
causes of excitement, plenty of fire and spirit, and an absence of 
any apathy, dullness, awkwardness of movement or position of the 
limbs, or of any other sign of failing nervous power he may be 
considered free from this afiFection, even if he refuses to back in a 
docile manner. In other cases there is a distinct physical inca- 
pacity quite apart from any brain disorder. Sprains or anchy- 
losis of the back or loins or anchylosis or painful arthritis of the 
hocks, may hinder backing. 

The diagnosis from e^ncephalitis and other inflammatory affec- 
tions associated with stupor, rests on the absence of h5^rthermia, 
of the congestion of the orbital and nasal mucosae, of the heat of 
the head and of the paroxysmal attacks of excitement which char- 
acterize these diseases. 



CEREBRO-SPINAL MENINGITIS. 

Definition. Epizootic manifestations. Faulty hygiene, insanitary stables, 
impure air, defective drainage, fermenting food, overwork, overfeeding, ex- 
citement, heat exhaustion, electric tension. Probably complex. Horse, 
ox, sheep, goat, dog. Microbian factors in man and rabbit. Lesions : 
meningeal, brain and spinal congestion, effusion, suppuration, circumscribed 
necrosis, softening, petechis. Blood dark, fluid or a diffluent clot. Symp- 
toms : horse : paresis, anorexia, dysphagia, mucous congestion, reddish 
brown : in severe cases, chill, stupor, apathy, debility j palsy, tonic spasms 
of neck, back or loins, hypereesthesia, twitching, trismus, hyperthermia, 
delirium, coma, convulsions, and early death. Duration averages 7 to 15 
days. Ox, as in encephalo-meningitis. Sheep, microbes. Do^, dulled 
senses, stupor, coma, palsy, hyperthermia, heat of head, spasms, etc. Diag- 
nosis : by brain and spinal symptoms ; cases in groups. More sudden than 
tetanus, or rabies, and shows no mischievous purpose, nor depraved appe- 
tite : from tubercular meningitis. . Treatment : Avoid suspected stable, 
food, water, or supicious environment, disinfect, correct local diseases, 
unload bowels, belladonna, atropia, chloral, bromides, ergot, phenacetin, 
potassium iodide. Bleeding. Cold to head or back. Derivatives. Sling. 
In convalescence, regulated diet and tonics. 

Definition, Concurrent inflammation of the meninges of the 
brain and spinal cord. 

This appears at times in many horses in the same locality, as in 
New York in 1850 (Large), in Denmark since 1852 (Stockfleth, 
Bagge), and in Egypt in 1876 (Apostolides). In Cairo alone 



Cerebrospinal Meningitis 119 

about 6,000 horses, mules and donkeys perished. Hence the 
disease is known as epizootic cerehros pinal meningitis. But again 
it is often seen in scattering or sporadic cases. Add to this that 
no evidence has ever been adduced that the disease is communi- 
cated from one animal to another, and in these days of the par- 
allelism of epizootics and pathogenic microbes, we may well 
hesitate about continuing to use such a qualifying term. Fried- 
berger and Frohner claim ** that a large number of clinical facts 
have been erroneously reported under the name of spasms of the 
neck. Rabies, tubercular basilar meningitis, apoplexy, simple 
encephalitis, and certain poisonings have been confounded with 
that disease. ' ' They assure us that * * cold, damp, chilly weather, 
hot stables, clipping and overfeeding are of but secondary im- 
portance," but they fail absolutely to tell us what is ol primary 
importance in a causative sense. American writers who have 
attempted to account for the disease have groped somewhat 
blindly for causes in the idea of poison. Large charged it on in- 
sanitary conditions, poisonous gases, and defective sewerage in 
cities, and lack of drainage and deficient stable ventilation in the 
country. J. C. Michener attributes it to foods undergoing fer- 
mentation and considers it as a paralysis due to toxic fungi. W. 
L. Williams, in Idaho, found the greatest number of cases in 
winter had been fed hay made from alfalfa (lucerne) and 
timothy, though some had small grains and native grasses. The 
soil was dry, porous, gravelly, devoid of humus, and lying on 
lava rock. The altitude and clearness of the atmosphere were 
supposed to* exclude the idea of cryptogams, yet the crops 
generally were raised by irrigation. The water was from clear 
mountain streams. Stables were generally low and full of 
manure, with thatched roofs, but hardly tight enough to be 
called close. In these cases the defective stable room, the irriga- 
tion, the leafy hay (lucerne), and the probable presence of fer- 
ments (bacteria), are the only suggestive conditions. In a fatal 
outbreak which I saw among the Wilkesbarre, Pa., pit mules, 
rain-soaked and badly fermented timothy hay, overwork in view 
of a strike, and a Sunday's holiday in an unshaded yard under a 
hot July sun, in contrast with the previous darkness and coolness 
of the pits, coincided to disturb the general health. In several of 
the Southern States it is attributed to worm-eaten com. Trum- 



I20 Veterinary Medicine, 

bower thinks it should be traced to the parasitic fungi that grow 
on plants, grains, and vegetation. In many instances the disease 
has appeared simultaneously with the feeding on certain speci- 
mens of brewer's grains, oats and hay, so that to use Trum- 
bower's words these were the carriers if not the prime factors of 
the disease. 

In recognizing how much cryptogams and bacteria vary under 
diflFerent conditions of life, and what various products they elab- 
orate at diflFerent stages of their growth, we can theoretically ex- 
plain the absence of the disease at one time and its presence at 
another under what seem to be identical circumstances, as also 
the variety of symptoms shown in diflFerent outbreaks. While 
this causation cannot be said to be absolutely proved, it is not 
antagonistic to the facts in many of the best observed outbreaks, 
and may serve as a h3rpothetical working theory until actual 
demonstration can be furnished. The aflFection suggests a nar- 
cotic poison introduced from without, rather than a disease due 
to a germ propagated in the system. 

This need not, however, exclude the operation of attendant 
conditions such as over work, plethoric feeding, excitement, close 
stables, heat exhaustion, etc., which tend to bring about cerebro- 
spinal congestion. Even the electric tension of Idaho, of the 
United States generally, and of Egypt, in connection with their 
comparatively dry atmosphere, should not be overlooked in con- 
sidering the possible causative factors. 

In all probability as we learn more of the true pathology of the 
disease, we shall come to recognize not one, but several toxic 
principles, and several diflFerent aflfections each with its character- 
istic phenomena in the somewhat indefinite aflFection still known 
as cerebro-spinal meningitis. 

The malady has been described in horses, oxen, sheep, goats 
and dogs, attacking by preference the young, which are not yet 
inured to the unknown poison, and by preference in winter and 
spring, the periods of close stabling, dry feeding and shedding of 
the coat. 

In the absence of bacteriological data from the horse, it maybe 
noted that in man cerebro-spinal meningitis, has been commonly 
found to be associated with the presence in the meningeal exudates 
oi th^ micrococcus pneumonia crauposa^ (Micrococcus lanceolatus 



Cerebrospinal Meningitis 121 

encapsulatus). This is frequent in the mouths of healthy per- 
sons so that some additional accessory cause must be invoked to 
increase the susceptibility or lessen the protective power of the 
tissues. This has been thought to be found in the concurrent 
presence of other bacteria, the staphylococcus pyogenes aureus, 
pneumobaccillus of Priedlander and the streptococcus pyogenes. 
Mosny appears to have established this for the staphylococcus in 
the case of rabbits. With a given dose of the micrococcus pneu- 
moniae death was always delayed for a fortnight, while with 
the same dose thrown into one thigh, and the staphylococcus 
aureus in the other, the rabbit died in one day. This enhanced 
potency resulting from the presence of the golden staphylococcus 
has been invoked to account for the germ making its way from 
the mouth to the brain in cases of otitis, suppuration of the 
Eustachian tube, tonsilitis or nasal catarrh. These remarks are 
intended to be suggestive, rather than conclusive, as we have 
as yet no certainty that cerebro-spinal meningitis in the horse 
is caused by the same germ as it is in man. 

Lesions, The lesions are usually those of leptomeningitis, or 
congestion of the brain and spinal cord and often eflFusion into 
the ventricles, with a serous exudation under the pia mater or 
into the arachnoid cavity. This may be transparent and yel- 
lowish, or grayish and turbid, or milky. In the sheep, Roloff 
has found purulent products under the pia mater, around the 
roots of the spinal nerves, and in the surface layers of cerebral 
gray matter. The marked hyperaemia on the surface of the 
gray matter is a striking feature, and circumscribed areas of ne- 
crotic nervous tissue and softening are not uncommon. Pete- 
chiae are frequent on the meninges, the brain, heart, lungs and 
kidneys. Granular and fatty degenerations are also met with in 
these parenchymatous organs. The blood may be dark and 
liquid or diffiuent. 

Symptoms in the Horse. The mildest attacks are manifested 
by paresis, or loss of perfect control over the limbs, or loss of 
power over the tail, impairment of appetite and some diflSculty of 
swallowing, together with some congestion or reddish brown dis- 
coloration of the orbital and nasal mucosae. In other cases 
paralysis of one or more limbs may supervene but without 
marked fever or coma. 



122 Veterinary Medicine, 

The more severe forms are ushered in by violent trembling, or 
by stupor, apathy, and extreme muscular weakness, or actual 
paralysis. In such cases the animal may stagger or fall. Dys- 
phagia or inability to swallow is often a marked s5rmptom, the 
saliva falling in strings from the lips. Another common phe- 
nomenon is the rigid contraction of the muscles of the neck, back 
and loins, the parts becoming tender to the touch and a more or 
less prominent oposthotonos setting in. Twitching of the mus- 
cles of the shoulders and flanks may be noticed. Trismus also 
is sometimes seen. The breathing is usually rapid and catch- 
ing and the temperature 104° to 106°. The pulse may be ac- 
celerated and hard, or weak and soft, or alternating. The eyes 
are violently congested, of a brownish or yellowish red color, 
and the eyeballs may be turned to one side. Paroxysms of de- 
lirium may set in, when the animal will push against the wall, 
or perform any of the disorderly movements described under 
meningo-encephalitis. Sooner or later coma and paralysis super- 
vene, and death occurs in from five to forty-eight hours. In the 
most acute (fulminant) cases the animal falls and dies in convul- 
sions. On an average the disease lasts from eight to fifteen days. 
In the more favorable cases, without any supervention of coma, 
recovery may begin on the third or fourth day. 

Symptoms in the Ox. These are largely those of encephalo- 
meningitis. If they do not come on with the customary violence, 
there may be at first difficulty in prehension, mastication and 
swallowing of food ; a rigid condition of the muscles of the neck, 
back, and sometimes of the jaws, and twitching of the muscles of 
the limbs, neck, lips, or eyes. For a time there may be hyperaes- 
thesia, restlessness and irritability, stamping of the feet or shaking 
of the head, then there is liable to follow, dullness, apathy, stupor, 
coma and paralysis. As in the horse, the distinction from ordi- 
nary encephalo-meningitis will at times rest on the prevalence of 
the epizootic disease in the locality. 

Symptoms in Sheep. The attack is described as coming on 
with weakness, dullness, lethargy, salivation, convulsions, opos- 
thotonos, grinding of the teeth, succussions of the body and 
limbs, heat of the head, and stupor or paralysis unless death 
ensues during a paroxysm. The congestion of the head and of 
the encephalic mucous membranes, and the deviation of the eyes 



Cerebrospinal Meningitis. 123 

are constant features. Wischnikewitsch describes an extended 
outbreak in sheep in which the brain lesions were complicated by 
hepatization of the lungs, and bacilli were found in the various 
exudates. This reminds one of the presently accepted cause in 
man, which is, however, a micrococcus rather than a bacillus. 

Symptoms in Dogs. These are described as some aberration 
of the senses, which gradually merges into stupor, coma and 
paralysis. While the animal is able to keep on his feet he sways 
and staggers, runs unconsciously against objects, or walks in a 
circle. There is heat of the head, injected eyes, sometimes 
drawn back or squinting, oposthotonos, and general spasms oc- 
curring in paroxysms. The duration of the disease is about the 
same as in the horse. 

Differential Diagnosis. From other forms of meningitis this is 
easily distinguished. Fulminant cases almost all belong to this 
type, the fact of the coincident implication of brain and spinal 
cord is strongly suggestive of this form, and the occurrence of 
many cases at once, without any demonstrable toxic or thermic 
cause, is tolerably conclusive. From tetanus there is this added 
distinction, that the disease does not set in so slowly, the spasms 
of the neck and back are not so persistent, and stupor sets in 
early, in a way that is unknown in lockjaw. Rabies is recognized 
by the slow onset, the characteristic prodromata, the mischievous 
disposition, the depraved appetite, and by the history of its local 
prevalence. Tubercular meningitis in cattle has a similar asso- 
ciation with tuberculous animals in the same family or herd, and 
often by the local indications of tubercle elsewhere, emaciation, 
unthriftiness, cough, flbcculent and gritty nasal discharge, en- 
larged lymph glands, pharyngitis, mammary disease. 

Treatment. With a disease so iatal prevention should be the first 
consideration and especially when it appears in an enzootic form. 
Even in the absence of a definite knowledge of its germ or toxin, it 
is logical to avoid the locality, condition, food or water by which 
such germ or toxin has presumably entered the system, together 
with every unhygienic condition, which may have reduced the re- 
sistance of the S3rstem and laid it open to the attack. The animals 
should be removed to a dean, airy, building and the old one 
should be thoroughly emptied, purified and whitewashed, the 
lime-wash containing 4 ozs. of chloride of lime, or i dr, of mer- 



124 Veterinary Medicine, 

curie chloride to the gallon. Drains and gutters should have 
special attention and the animals should not be returned until the 
stable is thoroughly dry. A change of feed is imperative when 
there is any suggestion of damp, mustiness or fermentation, and 
even in the absence of such indications, since the ferments and 
their products may still be present in a dried condition. It should 
also be an object to correct any morbid or pyogenic condition of 
the pharynx, Eustachian pouch, nose or ear, by appropriate 
measures and the inhalation of sulphurous acid or chlorine may be 
resorted to with advantage. 

As medicinal treatment, Large advises to give at the outset i oz. 
aloes with one or two drs. of solid extract of belladonna and as an 
eliminant, derivative and nervous sedative there is much to be 
said for it. In case the difficulty of swallowing should prove a 
serious barrier a hjrpodermic injection of Y^ dr. barium chloride, 
I >^ to 2 grs. eserine, or 2 grs. hydrochlorate of pilocarpin to- 
gether with % grain of atropin, may be employed. As a sub- 
stitute for atropin, ergot, potassium bromide, chloral hydrate, 
chloroform, or phenacetin have been tried in diflFerent cases with 
varjdng results. Iodide of potassium has been employed with 
advantage in the advanced stages and in convalescence, and may 
be usefully employed in the early stages as a sedative to the nerv- 
ous system, a deobstruant and an eliminant, if not as a direct 
antidote, to the toxins. 

Bleeding is generally condemned, yet in acute cases where there 
are indications of active brain congestion, threatening convulsions 
or coma it may tend to ward off a fatal result. 

Cold applications to the head are generally commended. Bags 
of ice or snow, irrigation with cold water, or cooling by running 
water at a low temperature, through a pipe coiled round the head 
or extended along the spine, will meet the purpose. Applied con- 
tinuously this constringes the bloodvessels within the cranium as 
well as on its surface, lessens the exudation, and controls the pain 
and spasms. This may be advantageously associated with warm 
fomentations to the feet and limbs, friction, or even the applica- 
tion of stimulating embrocations to draw the blood to these parts. 
In the smaller animals even warm baths may be resorted to as a 
derivative, cold being meanwhile applied to the head and spine. 
This not only lessens the vascular pressure within the cranium, 



Abscess of the Brain. 1 25 

but secures elimination of toxic matters by both skin and kidneys. 
Cold pure water should be constantly within reach. 

A most important thing in the horse is to put him in slings, if 
he is at all able to stand with their assistance. In decubitus he 
rests on his side, with the head on the ground, and lower than 
the splanchnic cavities. The result is a gravitation of blood to- 
ward the head. In the sling, with the head fairly raised the 
gravitation is the other way and the head is depleted. If the 
patient is too ill to be maintained in the sling, he may be packed 
up with bundles of straw on each side, so that his breast may lie 
on a thickly littered bed, and his head may be elevated. 

When convalescence sets in care must be taken to nourish with 
non-stimulating, easily digested foods, gruels, soft mashes, pulped 
or finely sliced roots. In vomiting animals rectal alimentation 
may become necessary. The rise of cranial temperature or the 
aggravation of brain symptoms should be met as needed by the 
local application of cold, and potassium iodide and iron or bitter 
tonics may be given if they do not interfere with digestion. 



ABSCESS OF THE BRAIN. 

Infection, in traumas, meningitis, encephalitis, strangles, etc. Symp- 
toms : evidence of trauma, chill, hyperaesthesia, irritability, drowsiness, 
giddiness, stupor, spasms, paresis, coma, dilated pupils, congested mucosae, 
vomiting. Location indicated by muscular groups involved. Treatment : 
As in meningitis : trephining in hopeful cases. 

The formation of abscess in the cranial cavity has been re- 
ferred to in connection with injuries to the cranium and meningo- 
encephalitis. It may here be said in general terms that this ab- 
scess is a product of infection. In the horse the most common 
cause is strangles, and especially such cases as run a tardy or ir- 
regular cotirse with imperfect softening and limited suppuration 
in the submaxillary or pharyngeal region. It is to be looked on 
'as an extension of the purulent infection so as to cause a second- 
ary abscess. The same may occur in case of ordinary abscess in 
any distant organ. In the brain as elsewhere suppuration may 
result from direct local injury as in the case of blows by clubs, 
or yokes, running against walls or posts, falls, the effects of but- 



126 Veterinary Medicine. 

ting, injuries by bullets and otherwise. In these cases, as 
noticed under concussion, there may be two points of injury 
(and two abscesses) one, in the seat of the injury, and one in 
a deeper part of the brain, at the opposite wall of the cranium, 
Again abscess may result in the brain from extension from a 
similar process going on in the vicinity. Thus otitis extends 
through the middle and internal ear to the brain, and its start- 
ing point may have been more distant, namely, in the Eustachian 
tube, or pouch, or in the pharynx. 

The symptoms vary according to the size of the abscess, the 
rapidity of its formation and the amount of attendant congestion. 
In the common cases resulting from strangles, I have usually 
found the animal down, unable to rise, blind, amaurotic, with 
dilated pupils, congested mucous membranes, and occasional 
spasmodic movements of the limbs, neck and head. The S3anp- 
toms may, however, vary through hyperaesthesia, irritability, 
drowsiness, giddiness, stupor, local or general paralysis with oc- 
casional spasms or convulsions. There may be an initial shiver- 
ing, and a rise of temperature, yet as pressure on the brain in- 
creases it may become normal or subnormal. In circumscribed 
abscess the symptoms may be much less severe, not perhaps ex- 
ceeding irritability, drowsiness, and some paresis or local 
paralysis. 

In some such cases one can trace the connection with some pri- 
mary disease, (traumatic injuries to the cranium, abscess of the 
diploe or sinus, parasites in the sinus, otitis, or pharjrngeal dis- 
ease) which serve as an indication of the true state of things. 
In others there may be circumscribed local manifestations (anaes- 
thesia, hyperaesthesia, hemiplegia, paralysis of special muscular 
groups, or spasms of the same) which may indicate more or less 
accurately the exact seat of the lesion. When well defined, this 
localization of the resultant phenomena, serves to distinguish this 
and other local lesions, from meningitis which is apt to be much 
more general in its diffusion. In the carnivora and omnivora 
vomiting is a marked symptom. 

Treatment of brain abscess is usually hopeless, yet the at- 
tendant inflammation may be met as in other cases of meningitis. 
If the seat of abscess can be ascertained surgical interference is 
fully warranted. 



TUBERCULAR MENINGITIS. 

I^ittle seen in cattle. Acute and chronic cases. Miliary tubercles in pia. 
Hydrocephalus. Progresses slowly. Irritability, hypercesthesia, photo- 
phobia, congested conjunctiva, grinding teeth, spasms, squinting, dilated 
pupils, congested disc, drowsiness, stupor, coma, palsy. 

Tubercle of the encephalon has been little noticed in the lower 
animals, partly because it is especially a disease of early life, 
while animals usually contract tubercle later in life, and partly 
because subjective symptoms are inappreciable, and the cranium 
is seldom opened in post mortem examinations. As the af- 
fection usually appears as a secondary deposit, the tubercles else- 
where go a long way toward identifying the nature of the disease 
in the brain. It has usually been found consecutive to pulmon- 
ary tuberculosis. 

In a case reported by Fischoeder as seen at the Bromberg 
abattoir, in a 350 lbs. calf, the animal had shown weakness, 
stupor and a tendency to fall toward the right. The brain lesions 
consisted of small foci of tubercle on the posterior pillars of the 
fornix (trigone) and adjacent parts. The left eye had on its 
inner aspect, near the junction of sclerotic and cornea, a firm mass 
with tubercular centres, extending inward as far as the retina. 
The bronchial mediastinal, prepectoral, brachial and precural 
glands were tuberculous. 

In a case in a cow reported by Lesage there were unsteady 
gait, impaired vision, and great timidity. Necropsy showed a 
suboccipital tubercle extending into the frontal sinus and cranium, 
and invading the brain near the parietal lobe for more than an 
inch. There were retro-pharyngeal and pleural tubercles as well. 

In a case of Routledge's, with extensive recent exudate, the 
condition advanced from apparent health to extensive paralysis 
in three days, while in a case which the author obtained in 
slaughtering a tuberculous herd no special nervous symptoms had 
been noticed during life. Much therefore depends on the rapidity 
as well as the seat of development. 

The primary lesions in the brain are of the nature of miliary 
tubercles in the pia mater which becomes congested, rough, gran- 

127 



128 Veterinary Medicine, 

ular, and throws out a free serous secretion. Thus hydrocepha- 
lus is a usual concomitant of the affection. 

The disease is characterized by its slow advance in keeping 
with gradual increase of the tubercle and is thus distinguishable 
from the more acute congestions and inflammations. The earlier 
stages are usually marked by nervous irritability, hyperaesthesia, 
intolerance of light, closed eyelids, congested conjunctiva, grind- 
ing of the teeth and even spasms partial or general. The second 
stage shows somnolence, deepening into stupor or coma, or there 
may be going in a circle or other irregular movement. Squint- 
ing usually convergent, dilated pupils and congestion of the optic 
disc frequently occur. The sleep, stupor, paralysis or coma may 
set in early and is usually largely due to the amount of exudation 
and the rapidity of its effusion. 



TUMORS OF THE BRAIN. NEOPLASMS. 

Bxistence inferential with similar external tumors. Cholesterine tumors 
on plexus of lateral, third or fourth ventricle : pea to egg : in old ; con- 
centric layers with abundant exudate. Symptoms : slight, or excitability, 
dullness, vertiginous paroxysms with sudden congestions, as in encepha- 
litis, sopor, stupor, paresis, coma. Melanoma : mainly meningeal ; pea to 
walnut ; with skin melanomata in gray or white horses. Cases. Pigmented 
sarcomata. Diagnosis, inferential. Psammoma : advanced cholesteatoma, 
melanoma, fibroma, etc.: osteid tumors. Nervous irritation, delirium, 
spasms, nervous disorder, and paroxysms. Myxoma : contains mucin ; 
cells (in homogeneous matrix) round, spindle-shaped or stellate. Changes 
to fat (cholesterine). CEdematous connective tissue, neoplasm. Myxo- 
lipoma. Myxo-cystoid. Symptoms. 

Tumors in the brain are not marked by distinct pathognomonic 
symptoms, so that their presence is to be inferred as a probability 
rather than pronounced upon as a certainty. 

The most common forms in the horse are cholesterine (choles- 
teatoma), melanotic (melanoma), sandy, gritty, ( psammoma) » 
and fibrous (fibroma). 



CHOLESTEATOMA. 

These are tumors formed largely of the peculiar fat which is 
found in bile and brain matter, and that crystallizes in flat oblong 
scales with a notch at one corner. The tumors are usually con- 
nected with the choroid plexus and developed beneath the pia 
mater, and may be of any size from a pea to a hen's egg, or in 
exceptional cases a sheep's kidney. As a basis there is a stroma 
of connective tissue permeated by bloodvessels from the plexus. 
Groups of spherical or polygonal cells fill the interstices while 
fusiform cells are found in the stroma. There is a variable 
amount of phosphate or carbonate of lime which in oldstanding 
cases may give a cretaceous character to the mass. These consti- 
tute sandy tumors (psammomata). 

Cholesteatomata are especially common in old horses and are 
manifestly connected with congestion of the choroid plexus and 
exudation. In a recent case or in a case which has shown a recent 
cerebral hyperaemia, we may find a central mass of yellowish 
cholesterine, and surrounding this an abundant yellow gelatinoid 
exudation. This latter is rich in cholesterine which fails to dis- 
solve along with the rest of the exudate on the occurrence of 
resolution, and is therefore laid up as the solid fatty material. 
For the same reason the fatty element is usually laid on in layers, 
one corresponding to each access of local hyperaemia and exuda- 
tion. The great tendency to calcareous degeneration has been 
attributed to the abundance of phosphate of lime in the cerebral 
exudate. 

The symptoms of these tumors are exceedingly uncertain. 
Many such tumors of considerable size have been found after 
death in animals in which no disease of the brain had been sus- 
pected during life. In these it is to be inferred that the accretions 
were slow, gradual, and without any serious congestion. In 
other cases the tumor is attended by paroxysms of vertigo, or in- 
dications of hyperaemia or meningitis, which will last for several 
days and gradually subside. It is reasonable to suppose that the 
tumors are largely the result of such recurrent attacks of en- 
cephalitis, and are no less the cause of their recurrence. The 
9 129 



130 Veterinary Medicine, 

intervals of temporary recovery correspond to the subsidence of 
hyperaemia and the reabsorption of the liquid portion of the 
exudate. The manifestations during an access correspond directly 
to those met with in encephalitis. As in that affection there is 
usually an initial period of excitement and functional nervous dis- 
order tending to more or less somnolence, stupor, paralysis or 
coma , with long intermissions of apparently good health . In other 
cases the stupor or paretic symptoms may persist up to the fatal 
issue. 



MELANOMA OF THE ENCEPHAXON. 

Black pigment tumors have been found in connection with the 
brain and especially the meninges, var3ring in size from a pea to 
a walnut, and as a rule, secondary to similar formations else- 
where. They are most common in gray horses which have 
turned white, and may give rise to gradually advancing nervous 
disorder. Bouley and Goubaux record a case of this kind at- 
tended with general paralysis. W. Williams reports the case of 
an aged gray stallion with melanomata on the meninges and in 
the brain substance which were associated with stringhalt of old 
standing. Mollereau in a vertiginous horse found a pigmented 
sarcoma in the right hemisphere between the gray and white 
matter, and like an olive in size and shape. There were melano- 
mata around the anus. ( Annales de Medecine Veterinaire, 1 889) . 
So far as such have been examined they follow the usual rule in 
melanomata in having a sarcomatous structure. 

While it is impossible to make a certain diagnosis without 
opening the cranium, the condition may be suspected, in gray 
horses, when melanotic tumors are abundant in the usual ex- 
ternal situations (anus, vulva, tail, mammae, sheath, lips, eye- 
lids, etc.), and when brain symptoms set in and progress slowly 
in such a way as to suggest the gradual growth of a tumor. 

Treatment is hopeless, since if they have invaded the brain, 
the tumors are likely to be multiple in the organ, and numerous 
and widely scattered elsewhere. 



PSAMMOMATA (GRITTY TUMORS) OF THE BRAIN. 

As already noted these sandy tumors are often the advanced 
stage of cholesteatomata, the abundance of the phosphate of lime 
leading to its precipitation in the neoplasm. The same cretaceous 
deposit often takes place in old standing tumors of other kinds, as 
in melanoma, and fibroma so that the sandy neoplasm may be 
looked upon as a calcareous degeneration of various forms of 
intracranial tumors. The same tendency to calcareous deposit is 
seen in the tuber cinereum (pineal body) of the healthy brain 
which has taken its name from the contained gpitty matter. This 
tendency to the precipitation of earthy salts may be further recog- 
nized in the osteid tumors which occasionally grow from the dura 
mater. 

The gritty tumors are especially found in the older horses in 
which the tendency is greatest to extension of ossification and 
calcic degenerations. 

Like other tumors these may attain a considerable size before 
they give rise to any very appreciable symptoms, but having 
attained a given development — often the size of a walnut, they 
become the occasion of nervous irritation, delirium and disorder, 
as indicated under encephalic hypersemia and inflammation, 
cholesteatomata, etc. There may, however, be drowsiness, stupor, 
coma, or paralysis as the exclusive symptom, or there may be 
spasms and convulsions. 



MYXOMA OF THE BRAIN. 

Myxoma is a tumor in which mucoid elements or a gelatinoid 
degeneration and infiltration containing mucin is a prominent 
feature. The mucous tissue which constitutes the tumor may differ 
little from ordinary connective tissue except that the intercellular 
spaces contain mucin. Histologically the tissue consists of cells 
embedded in a homogeneous matrix. The cells may be of va- 
rious forms, round, in recent formations and spindle-shaped or 
star-shaped, but especially the latter, in the older. When incised 
a fluid containing mucus escapes in greater or less abundance. 
131 



132 Veterinary Medicine, 

While this has properties resembling albumen it is distinguished 
by the fact that the precipitate thrown down in it by alcohol is 
softened and redissolved on the addition of water. The precipi- 
tate thrown down in an albuminous liquid is insoluble in water. 

The formation of this mucous exudate is liable to be followed 
by fat so that Virchow considered it as antecedent to fat forma- 
tion. This is especially noticeable in the early stages of the 
cholesteatomata of the choroid plexus of the horse, in which, as 
observed by Fiirstenberg, Lassaigne, and Verheyen, the new for- 
mation is at first a myxoma, which later becomes filled up with 
cholesterine. 

Recent observations tend to discredit the alleged distinctive 
character of myxoma. The meshes of all connective tissue con- 
tain a perceptible amount of mucin. CBdematous subcutaneous 
connective tissue contains this mucin in greater proportion and 
approximates to the condition of mucous tissue. The umbilical 
cord, which has been long advanced as the physiological type of 
mucous tissue, has been shown to consist of ordinary connective 
tissue with an abundance of fluid in its meshes. 

Koster denies that the myxoma is a special type of tumor and 
holds that it is only a condition that may arise in any tumor 
which contains connective tissue. In other words, myxoma is 
only an oedematous condition of the connective tissue neoplasm — 
fibroma, sarcoma, carcinoma, etc. — due to passive congestion or 
other circulatory disturbance. 

As seen in the brain of the horse the formation is usually of the 
nature of a myxo-lipoma, as the final outcome is usually the 
cholesterine bearing mass. In other cases the connective tissue 
spaces become further distended with the viscous, gelatinoid 
liquid and form veritable cysts — myxoma-costoides. 

In tumors of this kind affecting the choroid plexus the chain 
of symptoms is essentially the same as given under cholesteatoma 
and the prognosis is nearly equally grave. It need only be said 
that in recent cases in which there is as yet little permanent 
tissue, measures may sometimes be hopefully adopted, to secure 
the reabsorption of liquid constituents, and even perchance to re- 
move some obvious cause of passive congestion upon which the 
effusion depends. 



ACROMEGALY. HYPERTROPHY OF THE PITUITARY 

BODY. 

Like other portions of the brain the pituitary body is subject 
to degenerations and diseases of various kinds. This is particu- 
larly mentioned here because of the occasional association of its 
hypertrophy with the trophic processes of different parts of the 
body. Along with an over-development of the limbs, and less 
frequently of the body, an enormous increase of the hypophysis 
has been foumd, and the one condition has naturally been set 
down as the result of the other. In some such instances, of over- 
growth, however, some other blood glands, such as the thyroid 
or thymus, have been found to be hypertrophied, so that at 
present it is difficult to do more than notice the association ob- 
served between the two conditions'. 



CEREBELLAR DISEASE. 

Cerebellum and coordination. Presmre on adjacent parts renders results 
uncertain. Generic symptoms, ataxia, titnbation. Marked 83rmptom8 with 
rapid morbid progress. Treatment : tonic, hjgienic. 

Whatever functions are exercised by the cerebellum there is 
no doubt of its control over muscular coordination. It is quite 
true that disease of any other part of the brain causing effusion, 
exudation or intracranial pressure will more or less completely 
arrest the functions of the cerebellum just as disease of the cere- 
bellum producing intracranial pressure will derange the functions 
of other parts of the encephalon. The general symptoms pro- 
duced in this way cannot therefore be accepted as indicating the 
precise localization of an intracranial disease. Dullness, stupor, 
coma, dilated pupils, choked discs, optic neuritis, and vomiting, 
are in this sense generic symptoms, which may in the absence of 
fever indicate dropsy, exudation, apoplexy, tumor, concussion or 
other lesion, and with hyperthermia may indicate encephalitis or 
meningitis. But if in the absence of these symptoms and of aural 
133 



134 Veterinary Medicine, 

disease there should appear ataxia, swaying unsteady gait, and 
staggering, there is a strong presumption of cerebellar disease. 
This may also be manifested by the other and generic symptoms 
already mentioned only the diagnosis is not then so certain. 
Again cerebellar disease may exist without the ataxia and lack of 
balance, but probably .only in cases in which the progress is slow 
and the organ has had ample time to accommodate itself to the as 
yet comparatively restricted lesions. .The result may be a mere 
defect of muscular tone, or it may extend to an almost absolute 
loss of contractility, or it may be of any intermediate grade. 

Treatment, which is eminently unsatisfactory, consists in im- 
proving the general health and tone, by corroborant medicines 
and conditions of life, and training the muscles by carefully grad- 
uated exercise and even electricity. 



BULBAR PARALYSIS. DISEASE OF THE MEDULLA 
OBLONGATA. 

Impaired innervatioii of bnlt>ar nenrea. Paresis of lips, tongue, and 
larynx. Roaring. Rapid pulse. Glycosuria, albuminuria. Ptosis. Twitch- 
ing eyelids. Dysphagia. Paralysis. Treatment, rest, cold to head, laxa- 
tives, nerve stimulants, tonics, electricity. 

The bulb is intimately connected with the origin of the hypo- 
glossal, glosso-pharyngeal, spinal accessory, vagus, facial, and tri- 
facial nerves and active disease in the bulb is therefore likely to 
entail impairment of the function of several of these nerves. In 
man this is recognized in chronic progressive bulbar paralysis, 
which almost always affects the lips, tongue and larynx advance- 
ing steadily though slowly to a fatal termination. In degenera- 
tive lesions there is modified voice, diflBculty of swallowing, rapid 
pulse, and laryngeal paralysis (especially of the ar3rtenoid 
muscles). The implication of the root of the vagus may be in- 
ferred from the arrest of inhibition of the heart, and from glyco- 
suria or albuminuria. Occasionally the ocular and palpebral 
muscles are involved causing ptosis, or twitching of the muscles. 
When the facial (7th) nerve is implicated, paralysis of one or both 
sides of the face may be marked, including often the ears. When 



Loco Poisoning, Oxytrofns Lamberti, 135 

the glosso-pharyngeal, the diflBculty of swallowing is a prominent 
feature, and when the spinal accessory, spasm or paralysis of the 
neck. In the worst cases death supervenes early, by reason of 
interference with the respiratory and cardiac functions. 

The treatment of these affections is usually very tmsatisf actory, 
though in meat producing animals it may sometimes be desirable 
to preserve them in preparation for the butcher. Rest, in hyper- 
aemic cases, cold to the head and purgatives, and in those in which 
fever is absent, small doses of nerve stimulants (strychnia) and 
tonics (phosphorus, phosphates, ammonia-sulphate of copper, 
zinc sulphate, silver nitrate) may be tried. A course of arsenic 
and carefully regulated electrical stimuli may at times give good 
results. 



LOCO POISONING. OXYTROPIS LAMBERTI. ASTRA- 
GALUS MOLLISSIMUS. 

Astngalns Hornii : A. Lentiginosns : A. MoUisiniiu : Ozytropis Lam- 
berti : O. Mnlttfloris : O. Deflexa : SophoraSerecia : Malvaatnun Cocciiiiaiii : 
Corydalia Anrea. In diy regiona: Canae, a paycfaosta. Bmaciation. Laaii- 
lode. Impaired sight. lUtisions. Vice. Refiiaes other food. Contradic- 
tory views. Bzperimenta by Dr. Day. 

The term loco is of Spanish origin and has come to us through 
the Spanish speaking residents on the cattle raising plains and 
the Pacific Coast. The word is defined to mean fnad, crazy, 
foolish. It has been applied indiscriminately to a disease in stock 
manifested by these S3anptoms, and to a variety of leguminous 
plants, found growing on the western lands and supposed to cause 
the disease in question. The plants complained of are Astragalus 
Hornii, and A. Lentiginosus (Griesbach) in California, A. 
Mollissimus (Torrey) and Ox3rtropis Lamberti (Ptu^hiana) in 
Colorada and New Mexico. Other allied species, and like these 
fotmd also in the other Rocky Mountain States, Sophora Sereda, 
Ox3rtropis Multifloris, O. Deflexa, Malvastrum Coccinum, and 
Corydalis Aurea var. Occidentalis have been less confidently 
charged with producing the disease. 

These plants grow on poor, dry, sandy or gravelly soils, and 
having great power of resisting drouth, are often in fair growth 



136 Veterinary Medicine, 

and present an abundant mass of leaves when surrounding 
vegetation is withered up. Hence, it is alleged, the animals are 
driven to use it when nothing else is obtainable and once accus- 
tomed to it, the desire for more becomes a veritable craze or neu- 
rosis, and the victim searches for it and devours it to the exclu- 
sion of other food. 

The following quotations may serve to illustrate the effects 
alleged : 

Among the symptoms first noticed are loss of flesh,, general 
lassitude and impaired vision ; later the animaPs brain seems to 
be affected ; it becomes vicious and unmanageable and rapidly 
loses both flesh and strength. Frequently when approaching 
some small object it will leap into the air as if to clear a fence. 
The patient also totters on its limbs and appears as if crazy. 
After becoming affected it may linger many months, or a year, 
but usually dies at last from the effects of the complaint. (Dr. 
Vassey. Report of Dept. of Ag^culture, 1884). 

**I think very few if any animals eat the loco at first from 
choice ; but as it resists the drought until other food is scarce 
they are first starved to it, and after eating it a short time appear 
to prefer it to anything else. Cows are poisoned by it as well as 
horses, but it takes more of it to affect them. It is also said to 
poison sheep. As I have seen its actions on the horse, the first 
symptom apparently is hallucination. When led or ridden up to 
some little obstruction, such as a bar or rail lying in the road, he 
stops short, and if urged, leaps as though it were four feet high. 
Next he is seized with fits of mania in which he is quite uncon- 
trollable and sometimes dangerous. He rears, sometimes even 
falling backwards, runs or gives several successive leaps forward, 
and generally falls. His eyes are rolled upward until only the 
white can be seen, which is strongly injected and as he sees 
nothing, is as apt to leap against a wall or a man, as in any other 
direction. Anything which excites him appears to induce the 
fits, which, I think, are more apt to occur in crossing water than 
elsewhere, and the animal sometimes falls so exhausted as to 
drown in water not over two feet deep. He loses flesh from the 
first, and sometimes presents the appearance of a walking skel- 
eton. In the next and last stage he only goes from the loco Jto 
water and back, his gait is feeble and uncertain, his eyes are 



Loco Poisoning, Oxytropis Lamierti, 137 

sunken and have a flat, glassy look, and his coat is rough and 
lustreless. In general the animal appears to perish from starva- 
tion and consequent excitement of the nervous system, but some- 
times appears to suffer acute pain, causing him to expend his 
strength in running wildly from place to place, pausing and 
rolling, until he falls and dies in a few minutes. " ( O. B. Ormsby , 
Report Dept. of Agriculture, 1874). 

" Animals are not fond of it at first, or don't seem to be, but 
after they get accustomed to the taste they are crazy for it and 
will eat little or nothing else when loco can be had. There seems 
to be little or no nutrition in it as the animal invariably loses flesh 
and spirit. Even after eating of it they may live for years, if 
kept entirely out of its reach, but if not, they almost invariably 
eat of it until they die." (Mrs. T. S. Whipple, San Luis, Cal., 
Report Dept. of Agriculture, 1874). 

"Cattle, after having eaten it," Ox3rtropis Lamberti, "may 
linger many months, or for a year or two, but invariably die at 
last from the effects of it. The animal does not lose flesh appar- 
ently, but totters on its limbs and becomes crazy. The sight be- 
comes affected so that the animal has no knowledge of distance, 
but will make an effort to step over a stream or an obstacle while 
at a distance off, yet will plunge into it or walk up against it on 
arriving at it." (Dr. Moffat, U. S. Army.) 

" The term loco, simply meaning foolish, is applied because of 
the peculiar form of dementia induced in the animals that are in 
the habit of eating the plant. Mliether the animals (horses 
chiefly) begin to eat the plant from necessity (which is not likely) 
or from choice, I am unable to say. Certain it is, however, that 
when once commenced, they continue it, passing through a tempo- 
rary intoxication, to a complete nerv*ous and muscular wreck in the 
latter stages, when it has developed into a fully marked disease, 
which terminates in death from starvation or inability to digest 
more nourishing food. The animal, toward the last, becomes 
stupid or wild, or even vicious, or again acting as though attacked 
with blind staggers.' (Dr. Rothrock. Report of Dept. Agri- 
culture, 1884). 

Dr. Isaac Ott, of Easton, Pa., gives the following as the 
physiological action of the Astragalus MoUissimus ; " It decreases 
the irritability of the motor nerve, greatly affects the sensory 



138 Veterinary Medicine, 

ganglia of the central nervous system, preventing them from 
readily receiving impressions. Has a spinal tetanic action. It 
kills mainly by arrest of the heart. Increases the callory secre- 
tion. Has a stupefying action on the brain. Reduces the cardiac 
force and frequency. Temporarily increases arterial tension, 
but finally decreases it. Greatly dilates the pupil." (Amer. 
Jour, of Pharmacy, 1882. 

In opposition to these statements Professor Sayre, of Kansas, 
after an extended observation, arrived at the conclusion that ** it 
is a grave question whether loco weed is a poison at all ; upon 
chemical examination no poisonous principle of any kind was dis- 
covered ; no toxic effect was observable when administered to 
frogs, cats, dogs, or the human species, .... the point cannot 
be accepted as a settled one whether loco is poisonous to cattle or 
not." 

Dr. G. C. Faville found in locoed sheep in Colorado, bunches of 
tapeworms in the gall ducts. Dr. Cooper Curtice, who sub- 
sequently studied the subject, found the taenia fimbriata, and be- 
lieves that to these the sjrmptoms are exclusively due. ** The 
affected lambs are large headed with undersized bodies and hide- 
bound skins. Their gait is slightly like that of a rheumatic. 
They seem to have diflBculty in cropping the shorter grass ; they 
also appear to be more foolish than the other sheep, standing 
of tener to stamp at the sheep dogs or the herder than the healthier 
ones. Others do not seem to see as well, or are so affected that 
they seem to appreciate danger less. In driving they are to be 
found at the rear of the flock." (Animal Parasites of Sheep). 

It is altogether probable that the taeniasis of sheep has been 
mistaken for loco, but this can hardly account for the remarkable 
symptoms found in other genera of animals, as a concomitant of 
an acquired and insatiable fondness for these leguminous plants. 
The taenia fimbriata has been found in sheep and deer, but there 
is no record of it as a parasite of cattle and horses. 

Dr. Sayre' s failure to find any poisonous principle in the plants, 
or any toxic action on frogs, dogs or cats, cannot be received as 
conclusive in face of the result reached by others. Perhaps 
Dr. Sayre's specimens were not grown under the proper condi- 
tions, or were not collected in the proper season to secure the 
toxic ingredient. 



Loco Poisoning. Oxytropis Lamberti. 139 

Miss C. M. Watson, of Ann Arbor, Mich., succeeded in sepa- 
rating a small amount of alkaloid from the root of Oxytropis 
Lamberti, but did not apply the crucial test of physiological ex- 
periment. In the Report of the Department of Agriculture for 
1879, are given analyses of Oxytropis Laiiiberti, Astragalus 
MoUissimus and Sophora Speciosa, in each of which a small 
amount of alkaloid was found. 

In 1888-9, Dr. Mary Gage Day, of Wichita, Kansas, made care- 
ful experiments on cats and rabbits, under the supervison of Dr. 
Vaughan in the Michigan Laboratory of Hygiene. She used a 
decoction of roots, stems and leaves of plants gathered in Sep- 
tember and gave 60 to 70 c. c. of this to a half-grown vigorous kit- 
ten daily, along with abundance of milk and other food. In two 
days the kitten became less active, showed rough coat, increased 
desire for the loco, with partial loss of appetite for other food, 
diarrhcea came on, and retching and vomiting occasionally oc- 
curred. The expression became peculiar and characteristic. 
These symptoms increased, and emaciation advanced, and on the 
1 8th day periods of convulsive excitement supervened. These 
were sometimes tetanic, the head being thrown backward and the 
mouth frothing. At other times the kitten stood on its hind 
limbs and struck the air with its fore paws, then fell backward 
and threw itself from side to side. There were short intervals 
of quiet, life being indicated by breathing only. After 36 hours 
of these intermittent convulsions paraplegia set in, and the kitten 
died in two hours. There was no apparent loss of consciousness 
before death. 

Post mortem examination revealed gastric and duodenal ulcers, 
some of which were nearly perforating. The heart was in 
diastole ; brain and myel appeared normal ; the entire body 
anaemic. 

^o2i vigorous adult cat 60 c.c. to 70 c.c. of a more concentrated 
solution were given with other food. The results were essentially 
the same. By the twelfth day the cat was wasted to a skeleton 
and very weak. Paralysis of the hind limbs came on and the 
cat died on the thirteenth day. 

As a test experiment, two strong young cats were confined in the 
same place, fed from the same dish, and treated in every way the 
same, except that the one was fed daily a decoction of the loco. 



I40 Veterinary Medicine. 

The one fed loco accfuired the loco disease with the symptoms 
described above while the other, eating ordinary food only, re- 
mained healthy. 

Subcutaneous injections of the concentrated decoction thrown 
into frogs and chickens at the Michigan Laboratory, of Hygiene, 
under direction of Dr. Victor C. Vaughan, caused nervous twitch- 
ing and in large doses, death in i or 2 hours from heart paralysis. 
The same symptoms were produced in frogs by injection of an 
alcoholic extract of the residue left after evaporation to dryness 
of the decoction. 

The loss of appetite, acquired liking for the '* loco-weed,'* rough 
coat, emaciation, peculiar expression, rearing, plunging, and a 
staggering uncertain gait are among the S3anptoms given in the 
earliest published observation on the loco disease, and agree with 
the statements universally made by ranchmen. An ulcerated 
condition of the intestines was also pointed out by Professor 
Sayre in a locoed cow upon which he made a necropsy (Dodge 
City Times, July, 1887) : but the diarrhoea which was so marked 
a symptom in the cats experimented on, is not mentioned as a 
characteristic symptom in horses and cattle. 

* * From the close agreement of the symptoms in the cats with 
those universally recognized in locoed horses and cattle, I con- 
clude that the cases described above were genuine cases of the 
* 'loco disease " and are, so far as can be ascertained, the first 
that were ever experimentally produced." 

** The craving for the " loco " is soon acquired. The kittens 
would beg for it as an ordinary kitten does for milk, and when 
sUpplied would lie down contented. To determine whether a 
herbivorous animal would easily acquire the **loco habit*' a 
young * ' jack ' ' rabbit was captured and fed a few days on milk 
and grass; then fresh **loco'* was substituted for the grass. 
At first the ** loco *' was refused, but soon it was taken with as 
much relish as the grass had been. After ten days of the milk 
and **loco" diet the rabbit was found dead, with the head 
drawn back and the stomach ruptured." 

' * With reference to the character of the plants at the different 
seasons of the year, I am convinced by numerous experiments, 
on material gathered in different months, that the greatest 
amount of poison is present in the autumn and winter." The 



Lead Poisoning, Plumhism, 141 

scarcity of other food at that period of the year is only a partial 
explanation of the number of deaths occuring at that season. 

Conclusions : 

**ist. There is some poison in **loco weed" which may cause 
the illness and, if sufficient quantity is taken, the death of an 
animal." 

''2d. This poison is contained in the decoction obtained from 
the plants, and by systematically feeding it to healthy cats, cases 
of "loco" disease may be produced." 

**3d. Taste for the green * 'loco weed" may be experiment- 
ally produced in the jack rabbit." 

4th. From the large quantity of the plant or the decoction 
required to produce the disease, the poison must be weak, or if 
strong, it must be in very small amount. 



LEAD POISONING. PLUMBISM. 

Physiological action on nervona system. Sources : near smelting furnaces 
on vegetation ; paints ; paint scrapings in manure and on soils ; lead pack- 
ing of pumps, engines, etc. ; sheet lead ; bullet spray ; wall paper lead ; 
leaden water pipes or cisterns ; l^ad acetate ; painted buckets ; painted silo ; 
lead compounds in arts. Experiments on animals. Accidental poisoning : 
horse, fever, gray nasal discharge, salivation, convulsions, paralysis, 
dyspnoea. Cattle, emaciation, dyspoena, palsy, tonic spasm of flexors of 
limbs, swollen carpus, death in a few months. Young worst. Sheep, 
lambs paretic. Swine in pens escaped, those at lai^e suffered. Post- 
mortem ; lead or lead compounds in stomach, or shown by analysis, in 
gastric contents, liver, spleen, kidney, etc. Tests. Treatment : hydft>- 
sulphuric or sulphuric acid, sulphate of magnesia or soda, antispadmodics ; 
in chronic cases, potassium iodide, bitters. 

The physiological action of lead is exerted on the nervous sys- 
tem, so that lead poisoning may be appropriately enough treated 
of as a disease of the nervous system. 

Sources, The sources of lead as a poison for animals are 
extremely varied. In England in the vicinity of lead mines and 
smelting furnaces it is deposited from the air in a fine powder, 
and consumed with the vegetation. Herapath found that the de- 
posit, in dangerous amount, began half a mile from the chimney 
of the smelter and extended about half a mile further. 



142 Veterinary Medicine, 

A second source is in lead paints used about farms and the 
scrapings of paint pots thrown out with manure and spread 
upon the fields. These lead combinations will last for years in the 
soil or on the surface, being plowed under one year and turned up^ 
again the next when the occasion of their presence has been 
completely forgotten. In one case I found the red lead paint 
marked by the tongues of cattle at the back of an abandoned 
cottage the fence around which had been broken down. In 
another the scrapings were found in an orchard which had been 
near and convenient for throwing them out. In the third case a 
paint can hung on the branch of an apple tree, well out of the 
way of the stock as the owner fondly supposed, showed in its 
contents the marking of the barbed tongues of the cattle. In 
a fourth case a barrel of paint was set under the barn where 
there was not height enough to admit the matured cattle, 
but it bore the marks of licking by the young stock, and they 
alone died but in such numbers that tjie owner concluded 
it must be the ** Rinderpest." 

The lead packing' from the joints of pumps, engines and other 
machinery, thrown away around works and mines, is a common 
source of the trouble. I once found large quantities in the gas- 
tric contents of cows that had died around a coal mine in 
Ayrshire, Scotland. 

Sheet lead— ;tea-chest lead — is another common source of the 
poison. This is thrown out, scattered with the manure on the field, 
and will resist the elements for years but dissolves when taken 
into the acid stomach of the animal. 

The spray from bullets in the vicinity of rifle butts is another 
common cause of the poisoning. 

In one instance I have seen a cow poisoned by eating some lead- 
impregnated wall paper which had been carelessly left in the 
stable. 

Less frequently the poisoning comes from drinking water car- 
ried in leaden pipes, or left to stand in a leaden cistern. The 
softest waters — rain, snow, distilled water — are the most liable to 
this impregnation. The hard waters containing carbonates, sul- 
phates or phosphates, tend to be decomposed, the acid uniting 
with the lead to form comparatively insoluble carbonates, sul- 
phates or phosphates of lead, which protect the subjacent lead 



Lead Poisoning, Mumfnsm, 143 

against solution. The hardness of the water is not, however, a 
sufficient safeguard, as iron, solder, and other agents present in 
the lead as an impurity or merely resting upon it, are sufficient to 
set up a galvanic action resulting in solution. 

The salts of lead may find direct access to the animal, as in the 
case reported by Gamgee in which a farmer used a barrel which 
had contained acetate of lead for mixing the feed given to his 
stock. A somewhat similar source of poisoning is found in the 
use of buckets or silos which have been painted inside, and scale 
oflF in contact with hot water, etc. 

Bl3rthe enumerates the following compounds of lead as employed 
in the arts : 

I St. Hair dyes which have a basis of litharge, acetate or car- 
bonate of lead in combination with lime and other agents. 

2nd. White lead in its various forms is carbonate of lead. 

3rd. Newcastle white is white lead made with molasses vinegar. 

4th. Notingham white is white lead made with sour ale. 

5th. Miniature Painter's white is lead sulphate. 

6th. Pattison white is an oxychloride of lead. 

7th. Chrome Yellow is impure chromate of lead. 

8th. Turner's Yellow, Casella Yellow, Patent Yellow is oxy- 
chloride of lead. 

9th. Chrome Red is a bichromate of lead. 

loth. Red Lead is the red oxide of lead. 

nth. Orange Red is an oxide obtained by calcining the car- 
bonate. 

1 2th. Nitrate of Lead is much used in calico printing. 

13th. Pyrolignite of Lead is an impure acetate used in dyeing. 

14th. Sulphate of Lead is a by product in the preparation of 
acetate of aluminium for dyeing. 

Forms, Lead poisoning occurs in acute and chronic forms. 
The two forms, however, merge into each other and are largely 
convulsive and paralytic. 

Experimentally, Harnack found that 2 to 3 mgrms. in frogs 
and 40 mgrms. in rabbits caused increased intestinal peristalsis, 
diarrhoea, and paralysis of the heart. Dogs had choreic symp- 
toms. Gusserno gave 1.2 grm. to rabbits and dogs respectively, 
and produced emaciation, shivering and paralysis of the hind 
extremities. Rosenstein with 0.2 to 0.5 grm. obtained in dogs 



144 Veterinary Medicine, 

similar symptoms with epileptiform convulsions, and Heubel had 
symptoms of colic in a few cases. 

Casual or Accidental Poisoning. Metallic lead is slowly 
dissolved and therefore large doses of this may be taken in with- 
out visible ill eflFect. Shot has often been given to relieve the 
symptoms of broken wind in horses, and a dog at the Lyons 
Veterinary School took four ounces without visible ill effect. 
When finely divided, however, as in sheet lead or the spray of 
bullets it presents a much more extended surface to oxygen and 
adds, and in the acid stomach of monogastric animals, or even in 
the organic acids of the rumen it is dissolved in quantity suflBcient 
to prove poisonous. 

Symptoms in Horses, Shenton thus describes his cases. 
"There was a rough, staring coat, a tucked up appearance of 
the abdomen, and a slightly accelerated pulse ; in fact, symptoms 
of febrile excitement which usually, however, passed away in 
about a week. About this time large quantities of gray colored 
matter were discharged from the nostrils, and saliva from the 
mouth, but at no times was there any enlargement of the sub- 
maxillary, lymphatic, or salivary glands. Nor was there consti- 
pation of the bowels, which appears to be nearly always present 
in cases of lead poisoning in man. Fits and partial paralysis 
came on at intervals ; and when the animals got down they often 
struggled, for a long time ineffectually, to get up again. The 
breathing up to this time was pretty tranquil, but now became so 
difficult and labored that the patient appeared in danger of suffo- 
cation. The pulse was in no case above 60 or 70, and I ascribe 
the difficulty of respiration to a paralyzed state of the respiratory 
apparatus. The animals did not live more than two or three 
days after these symptoms appeared. The post mortem appear- 
ance varied but little. The lungs and trachea were inflamed ; 
the lungs engorged with large quatities of black blood ; the 
trachea and bronchia filled with frothy spume. In all cases but 
two the villous part-of the stomach presented isolated patches of 
increased vascular action, and in all cases the intestines, and 
especially the large ones, were inflamed. The blind pouch of 
the caecum was nearly gangrenous. There was nothing remark- 
able about the liver, spleen or kidneys, except that they were of 
a singularly blue appearance.* ' 



Lead Poisoning, Plumhism, 145 

Symptoms in Ruminants. These are described by Herapath as 
following the erection of lead smelting furnaces in the Mendip 
Hills in Somersetshire. There were stunted growth, emaciation, 
shortness of breathing, paralysis of the extremities, particularly 
the hinder ones, the flexor muscles of the fore limbs afifected so 
that the animals stood on their toes, swelling of the knees and 
death in a few months. Even if removed to a healthy locality 
the victims failed to thrive. The effects were most pronounced 
in the young. Lambs were bom paralytic ; at three weeks 
old they could not stand, and palsy of the glottis rendered it 
dangerous to feed from a bottle. Twenty-one out of twenty- 
three died early. The milk of cows and sheep was reduced in 
quiantity and quality, and contained traces of lead.. The cheese 
had less fat in it. The dead showed the mucous surfaces paler 
than natural and the lungs had large areas with abruptly circum- 
scribed margins of a dark red color, surcharged with fluid. A 
blue line appeared on the gum close to the teeth, and from this 
a globule of lead could be melted under the blowpipe. 

In the cases that have come under my observation paralysis of 
the hind limbs, emaciation and low condition, have been most 
prominent in the chronic forms, while these have been compli- 
cated by torpor of the bowels, blindness, stupor, coma, and more 
or less frequent paroxysms of delirious excitement or convulsions 
in the acute. In the chronic cases the blue line on the gums is 
an important symptom. 

Herapath noticed that near the smelting furnaces pigs escaped 
if kept in the pen but suffered if allowed to go at large. This is 
explained by the presence of lead in the forms of oxide, car- 
bonate and sulphate on the herbage, hay and hedge rows, and in 
short on all vegetation. 

In post mortem examination the stomach should be carefully 
searched for lead in the metallic form as sheet lead, bullet spray, 
etc. , for the different forms of paint of which lead forms an in- 
gredient, for the discarded white lead packing of pipes and ma- 
chinery, and even for solid masses of metallic lead. This is 
especially necessary in the case of cattle in which the morbid 
habit of eating non-alimentary matters is so common, and for 
which the sweet taste of some of the lead compounds seems to 
offer an attraction. The lead being long retained in the first 
10 



146 Veterinary Medicine, 

three stomachs in contact with acetic and other organic acids is 
especially liable to be dissolved and absorbed in dangerous amount. 
In the chronic cases especially, the test by electric current may 
furnish a valuable pointer. In lead poisoning the muscles respond 
much less actively to the stimulus than in the normal condition. 
In resorting to analysis the following table from Heubel of the 
amount of lead in the different organs of a dog may ofiEer a guide 
to the selection of an organ for examination : 

Liver .0310 .10 per cent. 

Kidney .0310 .07 ** 

Brain .02 to .05 ** 

Bones .01 to .04 ** 

Muscles .004 to .008 •* 

Professor George Wilson found the lead very abundant in the 
spleen, and used it for analysis. He dissolved it in aqua regia 
over a slow fife, cooled, filtered, evaporated, cleared, and boiled 
with dilute nitric acid. Then filtered and dried again, dissolved 
in dilute muriatic acid, and finally applied the color tests. With 
hydrosulphuric acid it gives a black precipitate, with sulphuric 
acid, a white, and with potassium iodide or bichromate a bright 
yellow. Or from the solution of the chloride the lead may be 
obtained as a metallic deposit on zinc from which it can be fused 
into a minute globule on charcoal. 

In the treatment of lead poisoning the first object is to prevent 
the further solution of lead in the alimentary canal and to carry 
it ofiE. To fill the first indication, hydrosulphuric acid or sul- 
phuric acid maybe administered to form respectively the insoluble 
sulphide or sulphate. As a purgative, sulphate of magnesia or 
soda should be preferred, as favoring at once elimination and the 
formation of an insoluble precipitate. Large doses are usually 
desirable, especially in ruminants, because of the bulky contents 
of the stomach and the torpor of the alimentary canal. If grip- 
ping is a prominent symptom opium or other antispasmodic must 
be added. 

In chronic cases, after the evacuation of the contents of the 
alimentary canal small daily doses of potassium iodide will serve 
to dissolve the lead out of the tissues, while sulphates may be 
given in small doses to assist in elimination from the bowels 
and to prevent reabsorption. The treatment by potassium iodide 
is equally applicable, to assist in the elimination of the lead that 



Alcoholic Intoxication, 147 

has passed into the circulation and tissues. The doses, however, 
should in any case be small to avoid the sudden solution of a 
large amount of lead which had been deposited in the tissues in a 
comparatively insoluble form. The sudden entrance into the cir- 
culation of any large amount of such lead would induce a prompt 
return of the toxic symptoms. A continuous exhibition of small 
doses is the course of wisdom and safety. The bowels should 
meanwhile be kept somewhat relaxed by small doses of sodium 
or magnesium sulphate. As a general tonic a course of bitters 
may be called for, especially when torpor or emaciation is pro- 
nounced. 



ALCOHOLIC INTOXICATION. 

Beer in pigs, alcohol in dogs, abtinthe in horse, alcohol and burnt ales in 
cows, alcoholized grain in fowls, also fermented raisins. Symptoms, lack 
of coordination, staggering, flashed mucosae, full pulse, stertor, sopor, coma, 
alcoholic breath, chill, muscular twitching, delirium. Treatment : ammonia 
acetate, or cartwnate, apomorphia, pilocarpin, warm water, coffee, stomach 
pump, electricity. 

Poisoning by alcohol is less common in the lower animals than 
in man, yet the veterinary journals record a considerable number 
of cases. We have seen pigs suffer from drinking soured beer ; 
the smaller breeds of dogs (English terriers) which are systemat- 
ically dwarfed by feeding alcohol are often kept for a length of 
time in a condition of semi-intoxication. Bissauge records the 
case of a horse inebriated by a glass of absinthe and a pint of 
white wine, and that of a cow which died intoxicated 24 hours 
after she had been given three quarts of pure alcohol (Rec. de 
Med. Vet. 1895). Dundas records intoxication in cows fed on 
Immt clUs, Intoxication of barnyard fowl and wild birds from 
eating grain soaked in strong alcoholic liquids has been frequent- 
ly noticed, and Bissauge reports fatal drunkenness among our 
domestic fowls from eating raisins and other fruits which had 
undergone fermentation. 

The symptoms are too suggestive to require notice in detail. 
There is a lack of coordination of movement, a staggering gait, a 
disposition to lie, dilated pupils, dark red flushing of the visible 
mucous membranes, a full pulse, stertorous respirations, drowsi- 



148 Veterinary Medicine, 

ness, stupor, and finally coma. The breath exhales the odor of 
alcohol, and the temperature usually falls, especially if the subject 
has been exposed to cold. It may rise later in connection with 
inflammation of the stomach or brain. Muscular twitchings and 
delirium are sometimes found, and may occur paroxysmally. 

Treatment, A pint of liquor of the acetate of ammonia to 
horse or ox may quickly relieve the symptoms, or i oz. carbon- 
ate of ammonia may be given in solution in a pint of vinegar. If 
more convenient the hypodermic injection of i or 2 grains of 
apomorphia, or of 5 grains of pilocarpin may be employed. Warm 
water is of the greatest value in securing elimination. A strong 
infusion of coflFee is very effectual. If the patient is a vomiting 
animal an emetic may be employed, and in case of coma the 
stomach pump may be resorted to. - Cold applied to the head or 
galvanism may be used to rouse the patient. 

In case of gastritis or encephalitis following the attack these 
must be treated according to indication. 



ANILINE POISONING. 

Compositioii. Source. Uses. Toxic action on skin, by inhalation, and 
by stomach. Symptoms : acute, chronic Test. Treatment : emesis, pur- 
gatives, stimulants, tonics, enemata, bleeding, normal salt solution. 

Aniline (Amidobenzene, Phenylamine, C, H, N) is a product 
of coal tar produced in the manufacture of benzole and of aniline 
dyes. Being an object of large production and consumption in 
the arts, its toxic action is seen not infrequently in man, and less 
so in animals. As used in confectionery it is so diluted that it is 
rarely or never injurious. On textile fabrics, however, it often 
causes cutaneous irritation, and when eaten by animals may be 
toxic. Workmen in the factories usually suffer from its inhala- 
tion. 

TumbuU gave Y^, dram sulphate of aniline to a dog, inducing 
vomiting \Vi2y2. hours and purging one hour later. There were 
accelerated pulse, labored breathing and paraplegia, followed by 
recovery in five hours. Other objective symptoms are coldness 
of the surface, and a bluish or purple color of the visible mucosae, 



Poisoning hy NitfthBemoL 149 

the blood failing to take up oxygen. In chronic aniline poisoning 
in man the following symptoms have appeared : papular, vesicular 
or pustular skin eruptions, or ulcers on hands, feet and scrotum ; 
an odor of coal tar ; anorexia, nausea and vomiting ; headache, 
vertigo, stupor, ringing of the ears, amblyopia, muscular spasms, 
muscular weakness, anaesthesia and motor paralysis especially of 
the extremities. The fatal dose is i }^ dr. and upward. 

Aniline may be extracted from the tissues by petroleum ether, 
and on the evaporation of the solution, it is left as an oily yellow- 
ish mass which gives the following reactions : — with a few drops 
of sodic hypochlorite a blue or violet blue ; with adds a rose red ; 
with bromine a flesh red. 

The treatment must be by eUmination by emesis, or purgation, 
by removal from aniline fumes or mixtures, and by stimulating 
and tonic agents. In place of emesis a stomach tube and lukewarm 
water in lai^ amount may be employed to wash out the stomach. 
For vomiting animals ipecacuan may be employed. Copious 
enemata may be given, along with purgatives, to dear out the 
bowels. As stimulants strong coffee, caffdn, camphor, or strych- 
nia may be employed. In case of profound stupor, prostration, or 
paresis it may be desirable to reduce the amount of aniline in the 
system by free blood-letting, care being taken to inject subcutem, 
or into a serous ca\nty, a nearly equivalent amount of normal 
salt solution. 



POISONING BY NITRO-BENZOL. 

Composition. Source. Uses. Chsncten. Toxic qualities. CodthI- 
sions ; paralysis ; cyanosis ; weak pulse ; bitter almond odor ; dark red 
mine ; sopor, giddiness ; rednced size of red blood globules ; congested 
brain, stomach, intestines. Treatment : emesis, purgation, stimulants, 
electricitj, deriTatiTes. bleeding, normal salt solution. 

Nitro-benzol (Nitro-benzine, C, H, NO, ) is a coal tar product, 
formed in large quantities in the manufacture of aniline dyes 
and extensively used as a flavoring agents for soaps, sweet meats, 
etc. It is formed by the addition of strong nitric acid to ben- 
zine, and appears as a yellow fluid with an odor resembling, 
yet somewhat different from, that of prussic add or oil of 



I50 Veterinary Medicine, 

bitter almonds. It may prove deadly to man or dog in a 
dose of fifteen drops, though most commonly it enters the system 
by inhalation. In animals the prominent symptoms are convul- 
sions and paralysis, supervening on a period of weak circulation 
and pulse, and blueness of the visible mucous membranes. The 
characteristic odor resembling the oil of bitter almonds exhales 
from the lungs and skin. In man there are dilatation of the 
pupils, blueness of the lips and nails, pallor of the face, weak 
pulse, slow breathing (often in the end Cheyne-Stokes respira- 
tion), a dark maroon or port wine color of the urine, and ambly- 
opia. In the chronic cases the skin is yellowish, and there are 
weariness, a dragging walk, headache, morning anorexia, 
drowsiness, giddiness, numbness of the hands or other parts and 
emaciation. The blood is chocolate color with red globules re- 
duced in size, in number and in haemoglobin, but containing an 
excess of carbon dioxide. The brain is often congested and the 
gastro-intestinal mucosa like the skin may be yellow (from al- 
leged formation of picric acid). In chronic cases disseminated 
sclerosis may be seen. 

In treatment emesis, purgation, stimulants (ammonia, cam- 
phor), galvanism, sinapisms to the chest, and phlebotomy, with 
injection of norilial salt solution, may be resorted to, as in aniline 
poisoning. 



POISONING BY CARBON BISULPHIDE. 

Used to kill insects in grain, etc., in bams. Locally anaesthetic, and irri- 
tant. Inhaled, toxic, causing excitement, anaesthesia, collapse. Large 
doses, excitement, reckless movements, incoordination, giddiness, sleep, 
stertor, paraplegia. Small doses, weakness, emaciation, tremors, paraplegia, 
polynria, mellitnria ; convulsions, death. Distortion and varicosity of axis 
cylinder, and unequal staining of cytoplasm. Treatment: pure air, good 
diet ; massage, electricity, tonics, phosphorous. 

This agent is largely used in vulcanizing and other factories 
where the employes are liable to sufifer, and also in granaries, 
bams, etc., for the destruction of insects in grain and other 
objects and where animals are liable to sufifer. 

Locally it acts like chloroform, when confined to the surface, as 
under a glass or covering, producing very active irritation with 
anaesthesia. 



Narcotic Poisons, 151 

/»A/z/f^it produces intoxication, excitement, general anaesthesia 
and finally collapse. In rabbits it causes intense excitement, 
giddiness, swaying from side to side, and reckless leaps forward, 
followed by profound sleep with deep stertor, and paraplegia for 
half an hour after the return of consciousness (Oliver). When 
taken for a long time in small quantity it caused weakness, 
emaciation, tremors, paraplegia, and death in convulsions. There 
was polyuria, with excess of sugar but neither urea nor albumin. 
The large cells in the motor areas of the brain, when stained by 
Golgi's method, showed the axis cylinder distorted and varicose, 
and the cytoplasm stained unequally. The action on dogs was 
essentially the same, and in neither animal were changes in the 
blood globules observed (Oliver). 

In man slow poisoning caused headache and exhilerant intoxi- 
cation, followed by depression, mental apathy, dullness, loss of 
memory, impaired vision, hearing, sexual desire and muscular 
power. Cramps are common (Delpech, Curtis). 

Treatment consists in giving pure air, good food, massage, 
galvanism, tonics, and for the persistent nervous failure phos- 
phorus. 



NARCOTIC POISONS. 

Among narcotics and other poisons affecting the nervous 
system may be named the following : 

Wild poppy which produces rabiform symptoms or coma ; 
also its alkaloids, and especially opium. 

Buckwheat when in fiour : causes intoxication like alcohol. 

Hyoscyamus, belladonna, stramonium, bittersweet, pro- 
duce weakness, paresis and palsy. 

Cannabis indica causes sluggishness, vertigo and staggering 
in camivora. Steeping of hemp in running streams is forbidden 
in some warm climates. Even flax is claimed to have caused 
staggering and convulsions. 

Skunk cabbage (dracontium), causes vertigo, nausea and 
vomiting. 

Wild garlic produces rabiform attacks. 

Valerian leads to cerebral disorder — notorious in cats. 

Hellebore causes coma, stupor, weakness and convulsions. 



152 Veterinary Medicine. 

Veratrum album, cevadilla and viride produce tremors and 
spasms. 

Ranunculus causes stupor, trembling, loss of lumbar reflex 
and sudden death. 

Digitalis paralyzes lips and hind limbs, with stupor and con- 
tracted pupils. 

CBnanthe crocata caused general paralysis. 

Conium maculatum led to anaesthesia, blindness dilated 
pupil, palsy and convulsions. 

Vetches, lupins, ryegrass, millet, etc., already named (Vol. 
II. and Meningitis). 

Fermented potatoes, chestnuts, beechnuts (see Vertigo). 

Ergot, smut, musty fodder, mouldy meal or bread (see 
poisoning by Cryptogams). 

Bitter almond cake, wilted leaves of choke cherry, 
hydrocyanic acid cause vertigo, tremors, paresis, epileptiform 
convulsions. 

Aconite leads to anaesthesia, paralysis and death. 

Tobacco entails nausea, vertigo, cardiac prostration, and 
death. 

Artemesia cinac and santonin cause in dogs epileptiform 
convulsions and paraplegia. 

Box leaves produced coma, vertigo and convulsions. 

Cicuta virosa determines epileptiform convulsions. 

Iodoform entails stupor, sopor, coma, and rabiform s)rmptoms. 

Strychnia, ergot and rhus cause tonic spasms. 

Coriaria Myrtifolia of Southern Europe yields a deadly 
narcotic glucoside. 

Fruit of the Umgamu of S. Africa makes an intoxicating 
drink acting on abimals and man. 

The Coca of Brazil paralyzes sensibility and is said to over- 
come fatigue. 

The Pareca, a species of inga of the Amazon valley acts in 
the same way : a snuff by a new subject causing him to fall as if 
shot, while the inured are exhilarated, and hunger, fatigue and 
depression are relieved. Captain Hemdon says it is made from 
the ashes of a vine, the seeds of the acacia angico and the leaves 
of the abuta (cocculus). When nearly dead with hunger, fatigue 
and fever, a snuff made him fall drunk in the hammock, his limbs 
feeling as if under an electric shock ; on rising he felt no pain and 



Tetany. 153 

seemed to dream, but outwalked the Indian guides for two hours 
till daylight. 

A dwarf bush of the mountains of Africa and a bulbous root 
of Nebraska are alleged to possess similar properties. 

The hydery — quill — rhay (Indian tobacco) is used in British 
Columbia and Alaska for the same effect as opium. 

Sleepy grass (Stipa inebrians and S. Siberica) of Texas and 
New Mexico causes profound sleep or stupor for one or two days. 
In horse causes diaphoresis and diuresis. 

Tutu (coriaria rustifplia) of New Zealand has poisonous seeds, 
acting even fatally on fatigued cattle and sheep, but not on horse, 
goat or pig. The narcosis lasts but a few hours. 

Treatment, Opium and some other alkaloids find an antidote 
in potassium permanganate, to be supplemented by diffusible stimu- 
lants. All may be counteracted by eliminants (vegetable emetics, 
laxatives and diuretics), seconded by abundance of water and 
other diluents. When the agent is acrid or irritant demulcents 
(boiled flaxseed, raw eggs, milk, slippery elm, albumen, mallow, 
g^ms, etc. ) should be used freely, and fomentations and poultices 
applied over the abdomen and loins. 



TETANY. 

Definition. Casoal and experimental cases in animals. Canses : Excision 
of the thsTToid, indigestions with fermentation, rhenmatism, infection, ma- 
laria, rachitis, want of hygiene, hereditary or developmental irritability, 
microbian poisons. Symptoms : intermittent spasms with semi- flexed 
limbs, tremors. Diagnosis : by the complete intermissions of spasms, and 
by pressure on nenre or artery, ronsing them. No fever. Like spasms of 
ergot. Treatment : thyroid extract, grifting thyroid ; remove sources of 
irritation, anti-spasmodics, warm or tepid baths, electricity. 

Definition, Tetany is the name given to a limited contraction 
of a group of muscles usually in the extremities occurring 
paroxysmally with intervals, during which it may usually be 
rotised into activity by compression of the nerve or artery pro- 
ceeding to the muscles in question. 

The disease has not been accorded a place in systematic works 
on veterinary medicine, though cases have been recorded which 
are supposed to have been of this nature, and in cases occurring 



154 Veterinary Medicine. 

in man and associated with dyspepsia and gastric dilation, 
Bouveret and Devic have extracted from the contents of the 
stomach a toxic substance which caused tetanic convulsions in 
animals. The total removal of the thyroid gland, or even of 
four-fifths of it (Eiselsberg), in the cat is found to be invariably 
followed by tetany. 

Causes, Beside the origin from the removal or general disease 
or degeneration of the thyroid, it has been attributed to digestive 
troubles, associated with fermentations and the production of 
toxic matters, to rheumatism, infection and malaria, to rachitis 
and unhygienic conditions. The systematic changes and trials of 
growth and development, of pregnancy and lactation, seem to be 
factors in certain cases. A peculiar irritable nervous organiza- 
tion transmitted by heredity is undoubtedly a potent cause, and 
upon this, bacteridian, leucocytic and other poisons operate so as 
to rouse the paroxysms. 

Symptoms. There are usually prodromata in the shape of dull- 
ness, prostration, weariness, and some dullness of the special 
senses. Fever is commonly absent and the contractions tend ta 
affect both flexors and extensors, but as the force of the first 
predominates, the affected member is usually held more or less 
rigidly semi-flexed. The spasm appears suddenly, often taking 
occasion of some voluntary movement, and may last for several 
minutes or hours. It is followed by an interval of relaxation of 
equally uncertain duration. Though usually attacking the limbs 
and causing the victim to walk on the toes, it may extend to the 
face, neck or trunk, and constitute an intermittent trismus, 
oposthotonos or emprosthotonos. 

Diagnosis. Tetany is to be distinguished from tetanus by the 
complete intermissions of the spasms, and by the voluntary de- 
velopment of these by compression of the presiding nerve or 
artery. Pressure on the nerve arouses its excitability, and com- 
pression of the artery shutting off the supply of blood from the 
disordered and susceptible muscles, tends to increase their irrita- 
bility. Ligature of an artery supplying healthy muscles causes 
simple trembling of such organs. From the spasms of cerebral 
spinal or meningeal inflammation tetany is distinguished by the 
absence of fever, and the complete intermissions of the paroxysms. 
The spasms of ergotism bear the closest relation to those of tetany 



Contraction of the Spinal Cord in the Horse and Cow, 155 

and in the absence of proof of the ingestion of ergot, might well 
be confounded with them. 

Treatment. This consists mainly in doing away with the causes, 
when these can be ascertained. Portions of th>Toid may be 
grafted if complete thyroidectomy has been performed, or thyroid 
extract may be given. In the human subject recoveries have 
followed the expulsion of intestinal worms, the cure of gastric 
dilation, dyspepsia, fermentations, diarrhoea, rachitis, menstrual 
irregularity, or auto-intoxication. Fire has seen recover>' follow 
the extraction of a carious tooth. 

The spasms may be met by the internal administration of anti- 
spasmodics C chloral, belladonna, bromides, opiates,) and the ex- 
ternal application over the affected muscles of anod>^es and 
anti-spasmodics ('belladonna, opium, chloroform, oil of cajeput, 
oil of peppermint, menthol, etc.). Warm or tepid baths are 
often of great value and a mild electric current has been found 
useful. 



CONGESTION OF THE SPINAL CORD IN THE HORSE 

AND COW. 

Under this heading Trasbot describes haemoglobinuria and par- 
turition paresis, but this tends to cover up the more important 
causes and phenomena of these diseases, which should be kept in 
the foreground. Spinal congestion is undoubtedly a feature of 
both these affections, and the sudden onset and rapid recoveries 
often seen, indicate the absence of inflammator>' action, yet this is 
but an accompaniment of a constitutional morbid state which we 
think fully warrants a special consideration of each elsewhere 
(see Haemoglobinuria ; Parturition paresis;. 

Apart from these affections congestion habitually merges into 
myelitis or spinal meningitis, and may be considered as the initial 
stage of these disorders. It owns the same causes and is mani- 
fested by closely allied symptoms, but these are less persistent, 
and may subside abruptly into a condition of health. The treat- 
ment will be on the same general lines as for myelitis, but with 
much better hope of success. 



ACUTE MYELITIS. POLIOMYELITIS. INFLAMMA- 
TION OF THE SPINAL CORD. 

Causes : Stimulating food to excess, sexual over- stimulation, violent over- 
exertion, hot sun, chill, rheumatism, traumas, injury to spinal nerves, ver- 
tebral caries, microbian infection, narcotics, vegetable poisons, cryptogams. 
Lesions : discoloration of white or gray matter, swelling, friability, soften- 
ing, extravasations in points, leucocytes in excess, nerve cells cloudy, granu- 
lar, nucleus enlarged, stain highly, chromophile granules irregular, neuro- 
glia thickened. Symptoms : Hyperthermia, rigor, hypersesthesia, tonic 
contractions in neck and limbs, intense lameness, paresis, palsy, muscular 
atrophy, areas of heat followed by coldness, such parts may not perspire, 
palsy less complete than in broken back, circulation and breathing acceler- 
ated or slow, paraplegia in large herbivora. Diagnosis : progressive onset, 
hyperaesthesia or rigidity merging into palsy, retention and later inconti- 
nence of urine, extreme spinal tenderness, rapid atrophy of affected mus- 
cles, skin sloughing. Prognosis, always grave. Treatment: purgation, 
bleeding, hot fomentations, ice bags, compresses, derivatives, bromides 
chloral, potassium iodide, atropia, ergot, electricity, strychnia, soft laxative 
food, bitters, phosphates. 

Causes, Like congestion this may be a result of plethora 
in overfed animals, in those subjected to specially stimulating 
food like gluten meal, cotton seed meal, beans, peas, vetches in 
excess, animal food for herbivora (the waste of hotels and restau- 
rants for cows, compressed meat products for pigs), a period of 
absolute rest on full rations in horses habituated to hard work 
and full feeding ; of sexual over-stimulation in males (stal- 
lion, bull, ram) ; of violent over-exertion especially if under 
a hot sun ; of sudden chill when over-fatigued and perspiring ; 
of cold rain storms (Freirier) ; of rheumatism (Kowalski) ; 
of traumatism (fractures, sprains, slipping with over-disten- 
sion) ; of falls upon the point of the ischium ; of blows upon 
the back (Cruzel, Trasbot) ; of tumors implicating the cord ; 
of too violent efforts in serving by stallions ; of injuries of 
the great nerve trunks passing off from the cord (Gull, Tras- 
bot, etc. ) ; of extensions from caries or suppurations of the 
vertebrae (Decoste, Trasbot); of microbian infection, as in 
rabies, distemper, tubercle, dourine, louping ill, milk sickness, 
contagious pneumonia, influenza, and suppurations : of narcotic 
156 



Acute Myelitis. Poliomyelitis, 157 

poisoning, as from ergot, smut, the poisons of the cryptogams 
and bacteria of mouldy bread, musty fodder, spoiled meats, fish, 
etc. ; also the poisons of lolium, vetch, lupin, astragalus, 
oxytropis, arsenic, etc. 

Lesions. These consist in a yellow or pink discoloration of 
the white and especially of the gray matter, and a special prom- 
inence of the puncta vasculosa in the affected part. Swelling or 
distortion of the part is not usual. This may involve only a 
single gray horn, the two horns on the same side, the two in- 
ferior horns, or all four at onc6, or the white matter adjacent 
may also show the rosy tint, the large puncta, and a charac- 
teristic softness and friability. Minute blood extravasations are 
very significant. Microscopically examined leucocytes are found 
in abundance in the perivascular spaces and in the neuroglia. 
The neurons (nerve ganglia cells) are degenerated, being 
cloudy, swollen, with enlarged nucleus, stain highly, and show 
enlargement of the chromophile granules. In a more advanced 
stage the cell has an indefinite outline and the nucleus is in- 
distinct and may fail to take a stain ; the chromophile granules 
are irregular and do not radiate evenly from a centre and many 
vacuoles appear. This may lead to fatty softening, or to fibrous 
increase of the neuroglia, and sclerosis. 

Symptoms. These vary greatly in different cases according to 
the part involved, the meninges or some special region of the 
cord, to the essential cause of the inflammation and its acuteness. 
Usually the attack sets in slowly in contradistinction to the 
abrupt attack of congestion. Hyperthermia and rigor are 
usually among the first symptoms, though in many cases hyper- 
aesthesia is the most marked early symptom. The skin covering 
the muscles which derive innervation from the affected section of 
the cord is the most sensitive. This is often so extreme along the 
vertebral column that percussion on the spinous processes or 
pinching between the fingers and thumb causes the most pro- 
nounced wincing and dropping of the back. Copland and 
Laposso have noticed that a sponge of hot water drawn along the 
line of the vertebrae causes acute pain and contractions of the 
muscles of the back and limbs, which are almost tetanic in their 
force. This probably implies the existence of meningitis, since 
the absence of rigidity of the muscles of the neck, back and 



158 Veterinary Medicine, 

limbs, usually implies the absence of meningeal inflammation. 
It may, however, occur in localized or commencing myelitis. 
The existence of unilateral lesions and rigidity determines intense 
lameness, which is further characterized by the most marked 
h3rperaesthesia. 

The morbid phenomena of the motor system are more 
characteristically paretic or paralytic than spasmodic. When 
rigidity or spasm ushers in the attack it is superseded in a few 
hours or in two or three days by flaccidity of the muscles of the 
affected part, with imperfect control or even complete paralysis. 
The muscles affected will depend on the seat of the spinal lesion. 
If in the neck it may affect fore and hind limbs, and even the 
chest and abdomen ; if in the back or loins it will induce para- 
plegia, the anterior limit of which will correspond to the seat of 
the lesion ; if near the caudal extremity of the cord, (lumbar 
portion), paralysis of the tail and of the sphincters ani and 
vesicae may be prominent features. Retention of urine and faeces 
(spasm) may precede incontinence (palsy). 

Common sensation may be dull or abolished on one or on 
both sides. If on one side only, the other may show hyper- 
aesthesia. 

Trophic modifications are very marked though they may 
not be noticeable at first. The paralytic muscles waste rapidly 
and the impaired nutrition is manifested in the rapid formation of 
sloughing and intractable sores where pressure comes in recum- 
bency (the hips, stifles, hocks, shoulders, etc.). This is 
especially noticeable on parts supplied by the cord at or behind 
the seat of the lesions. 

Vaso-motor changes are usually marked by a preliminary 
hyperthermia of the affected parts, followed by a corresponding 
hypothermia. Sometimes the affected part of the skin will re- 
main quite dry while the rest of the body is covered by perspira- 
tion. 

Choked optic disc and retinitis are sometimes present. 

The febrile reaction which is at first moderate, gradually in- 
creases in force ; the animals become dull, drowsy, careless of 
food, and the hyperaesthesia merges into paresis or paralysis. 
This is rarely so complete as in fracture of the vertebrae. If the 
inflammation is restricted to the lower columns only, there may be 



Acute Myelitis. Poliomyelitis. 159 

akinesis without change of the sensitiveness or with hypersensi- 
tiveness. If restricted to the upper columns there may be sensory 
paralysis on the opposite side. 

The heart sounds and pulse are usually altered, palpitations 
may appear early with acceleration and sharpness of the pulse, 
and this may alternate with a tardy slow pulse with intermissions. 
Breathing also becomes accelerated and in violent cases with 
trembling, though in moderate inflammation with effusion, soften- 
ing and degeneration, it is liable like the heart beats to become 
slow and tardy. 

When vertigo appears it may be attributed to extension to the 
bulb or cerebellum, or to the sympathetic implication of these 
organs. 

The frequency with which paraplegia occurs in the larger her- 
bivora suggests a special susceptibility of the lumbar portion of 
the cord, probably in connection with severe muscular effort of 
the hind limbs. 

In protracted cases the fever may run very high, being compli- 
cated by septic poisoning from the numerous cutaneous sloughs and 
sores, as well as by cystitis and nephritis. 

Diagnosis. This may be based on the progressive onset, unlike 
the sudden attack of congestion ; on the occurrence of primary 
fever with hyperaesthesia or even muscular rigidity, merging into 
a later paresis or paralysis ; on the retention of urine, followed by 
incontinence ; on the torpor of the rectum ; on the extreme ten- 
derness of the spine in the region of the inflammatory lesion ; and 
on the tendency to rapid atrophy of the affected muscles, and the 
death and sloughing of the skin under pressure over the promi- 
nent parts of the body. The definite localization of the muscular 
symptoms, and the different temperature and secretion of the 
affected part of the skin, from the unaffected, are further con- 
firmatory of myelitis. 

Prognosis, While always grave, myelitis induced by narcotic 
elements in the food which can quickly be eliminated from the 
system, and that which has not caused compulsory decubitus, or 
persistent retention of urine and faeces, may be considered as 
hopeful. When, on the other hand, the nature and extent of the 
lesions have entailed a prolonged paralysis, or in the large animals, 
(especially solipeds), a persistently recumbent position, there is 



i6o Veterifiary Medicine, 

little to be hoped for. The degenerated myel, and the badly 
wasted muscles, combine to prevent rising and the use of the 
limbs, the sloughing bed sores quickly poison the blood and 
general system, and the animal sinks beyond hope of remedy. 
Again, if the faeces accumulate in the rectum causing general re- 
tention of the bowel contents and fermentation, the shock to the 
nervous system and the toxins absorbed add materially to the 
prostration and danger. Finally the retained urine infected 
through the blood or by a catheter, quickly passes into ammoni- 
acal fermentation, with softening and detachment of the cystic 
epithelium, septic infection of the mucosa, and the extension of 
this infection through the ureters to the kidneys. The complica- 
tion of infective inflammation of bladder and kidneys introduces 
one of the most dangerous conditions possible. 

Treatment. In an acute case, at the outset, elimination of any 
extraneous poison should be sought as the first step toward a 
restoration of the normal spinal functions. Purgatives may be 
employed to this end, and if the case is urgent and without spasms 
immediate action may be sought by a hypodermic injection of 
1)4 gr. eserine and 2 grs. of pilocarpin. Meanwhile the horse 
may receive a dose of aloes, or the cow one of Epsom salts. 
Abundance of watery or demulcent liquids given by the mouth or 
as enemas, should not be omitted. 

When plethora has been a prominent factor and symptoms are 
urgent, a free bleeding (4 to 5 quarts for horse or cow) from 
the jugular vein may serve to relieve the vascular tension, 
dilute the vital fluid, and moderate the inflammation. Hot 
fomentations or sinapisms to the limbs, and even cupping on the 
neck and chest, may contribute to relieve the tension on the 
spine. When the temperature is already high, bags of ice may 
be applied to the tender parts of the spine or those indicated to 
be the inflamed parts by the groups of rigid or paretic muscles. 
Wet compresses or evaporating lotions may be substituted. In 
the absence of mustard, tartar emetic, biniodide of mercury, or 
euphorbium may be used, or even croton oil in a carefully 
guarded manner, but cantharides, oil of turpentine, and other 
agents calculated to irritate the kidneys are to be avoided. 

Bromides, hydrobromic acid, potassium iodide, chloral, or bel- 
ladonna may be availed of. Some prefer ergot, but this, like 



AcuU Myelitis, PoliomyeliHs. i6i 

strychnia, is of doubtful efiFect or positively, injurious in most 
cases in the early stages. Even in the early stages electricity 
may be used in the form of a constant current, which tends to 
vaso-motor contraction and a better tone of the capillaries. The 
electrodes may be applied along the aifected side of the spine so 
that the current may traverse the affected part. It may be kept 
up for ten to twenty minutes at a time and repeated daily. Any 
undue suffering under the current may be accepted as a demand 
for the reduction of its force or its suspension for the time being. 

When the h3rperthermia has subsided and the occurrence of 
paresis or paralysis demands nervous stimuli, these may be sought 
in counterirritants, strychnia, and interrupted currents of elec- 
tricity. The blisters already mentioned may be used. Strychnia 
may be used internally (horse or ox 2 grs., sheep ^ gr., dog ^ to 
tV gr.) or hypodermically (horse i>^ gr., sheep }i gr., dog ^^ 
to tHr g^- )• Should this excite the animal or aggravate the symp- 
toms it must be stopped and deferred until the inflammation shall 
have more completely subsided. The same remark applies to 
electricity which may be tried in the interrupted current, and 
graduated to the endurance of the patient or entirely abandoned 
for the time. 

If the patient is able to support itself on its limbs, it is best 
kept in a sling to avoid the formation of sloughs and sores. If 
it cannot so support itself a very thick soft bed of litter is essen- 
tial to avoid the sloughing and septic poisoning. Pood must be 
laxative and easily digestible such as mashes, hay tea, and boiled 
or pulped roots. Fresh green grass may be employed when ob- 
tainable. 

During convalescence a course of bitters with calcium phos- 
phate and carefully regulated exercise are important. In tardy 
cases Trasbot especially recommends cauterization. 



II 



SPINAL MENINGITIS. 

Complex CBBes. Microbian invasion. Lowered vital tone. Traumas. 
Poisons, parasites, tubercle, rheumatism, neoplasms, poisonous food. Symp- 
toms : Stiffness, tonic contraction, spasms, hyperaesthesia with warmth, 
enuresis, paralysis later. Treatment : parallel to myelitis : cold, anodynes, 
nerve sedatives, and anti-spasmodics. saline purgatives, diuretics. Iodine, 
electricity, cauterization. 

It is often diflScult to distinguish between spinal myelitis 
and meningitis in the lower animals, and the danger of confusion 
is greater because the two affections are often conjoined. Attacks 
appear to be often associated with microbian invasion of the 
membranes, but in its turn this is often favored by the lowered 
tone of the membranes through mechanical injury, circulatory 
disorder, trophic changes, or the action of poisons in the blood. 
Thus the condition may supervene on fractures, partial disloca- 
tions or sprains of the neck, back or loins, abscesses pressing on 
the spine, extension of septic inflammation from poll evil, fistu- 
lous withers, or arthritis of the vertebrae, penetration of the mem- 
branes by sharp pointed bodies ( Reindl found a darning needle 
in a cow's spinal canal), invasion by microbes in influenza, brust- 
seuche, dourine, rabies, milk sickness, distemper, pyaemia, sep- 
ticaemia, strangles, louping ill, or Texas fever. The toxins of 
tetanus may start similar trouble. The larva of cysticercus 
cellulosa may cause meningitis in dogs or pigs, the sclerostoma 
in the soliped, the filaria in dogs and strongle in a variety of 
animals. Tubercle of the meninges is not unknown, and rheu- 
matism is alleged as a cause. Neoplasms commencing in the cord 
act in a similar way, and the poisons of rye grass, millet, loco, 
lupins, tares and vetches may act on the membranes as well as 
on the myel. 

Symptoms, In the main these resemble those of myelitis and 
are often present at the same time, and it is only necessary to 
note those which are especially pathognomonic. The early rigors 
are followed by stiffness of the back shown in rising or walking 
and aggravated by motion. There may be tonic contraction of 
the dorsal and lumbar muscles amounting at times to opostho- 
tonos. The muscles of the limbs, chest or abdomen or some part 
162 



Acute Myelitis in the Dog, Meningo- Myelitis 163 

of them may be the seat of tonic or clonic spasms. The skin is 
nsnally hypersensitive and this is aggravated by heat. The urine 
is liable to be retained because of the pain of stretching to 
micturate. Paralysis usually follows and implies extension to 
the myel, compression of the cord by reason of exudation, or 
implication of the spinal nerves at the points of exit. In myelitis 
on the other hand the spasms may be entirely absent, and 
paralysis sets in early and extends rapidly according to the seat 
and extent of the lesion. 

Treatment, This will be along the same lines as in myelitis, 
being aimed at elimination of toxic matters, and the counteract- 
ing of the existing inflammation. Anodynes such as bromides 
and chloral and cold water or ice are especially called for to alle- 
viate pain and h3rperaesthesia, and anti-spasmodics like ether, 
chloroform, chloral, belladonna, etc., to allay the spasm. Saline 
purgatives too, and diuretics may be availed of to limit effusion 
and favor reabsorption. In the advanced stages iodine may be 
freely applied to the spine, and an occasional electric current, or 
cauterization may be availed of. 



ACUTE MYELITIS IN THE DOG. MENINGO-MYELITIS. 

Causes : distemper, in long-haired pets, pysemia, exposure to cold, vio- 
lent over-exertion, traumas, vertebral caries or abscess. Lesions : in lum- 
bar enlaiigement, horns yellowish, red, friable, pultaceous, leucocjrtes in ex- 
cess, punctiform extravasations, neurons opaque ; granular, filaments difflu- 
ent, varicose, sclerosis. Meninges congested, thickened. Symptoms : as in 
horse, extreme hypersesthesia, later anaesthesia, tremors or twitching, later 
paraplegia. Treatment : Laxatives, ice bags, sedatives, later derivatives, 
cauterization. During convalescence, phosphates, iron, zinc, strychnia. 
Attend to bladder and rectum, light, laxative diet, pure air and water. 

Causes, This disease is a common result of distemper and ac- 
cording to Trasbot, is much more frequent in long-haired and pet 
dogs than in the short-haired and mongrels. The shelter of the 
hair, like the warm indoor atmosphere, seems to contribute to a 
special sensitiveness of the cutaneous and nervous tissues. The 
infective inflammation of the myel is also seen in pyaemia, rabies 
and milk sickness. It appears to be further induced by ex- 



1 64 Veterinary Medicine. 

posure to cold draughts when heated, or excited, by plunging 
into ice cold water, by lying on cold^ damp, stone pavement or 
metallic plates. Violent over-exertion, excessive fatigue, and a 
variety of traumatisms are further factors. Kicks, blows on the 
back, concussion from falling from a window or other height, 
and sprains received in fighting or otherwise, are common causes. 
Disease of the vertebrae or abscesses in their vicinity will some- 
times extend to the meninges and cord. . 

Lesions. These are like those in the larger animals, being to a 
large extent determined by the cause and nature of the lesion, 
concussion, sprain^ fracture, pyaemic, septicaemic, or other in- 
fection. The implication of the myel to the exclusion of the 
meninges is very frequent and the lumbar enlargement is the 
most common seat of disease. I/>calization in the brachial en- 
largement or in one lateral half of the cord is uncommon. The 
gray matter towards the extremity of the horn is the most com- 
monly involved, reflecting a yellowish, grayish red or deep red 
color, and breaking down into a pultaceous mass on the slightest 
pressure. At an advanced stage the altered coloring matter 
gives to the tissue a brownish yellow color without altering its 
consistency. The still vital and vascular area around the centre 
of softening may be slightly swollen and abnormally firm, The 
neuroglia is the seat of leucocytosis, and minute ( usually puncti- 
form) extravasations of blood. The red globules are crenated 
or otherwise distorted and the white are granular and opaque. 
The neurons are swollen, granular and opaque and the nerve 
fibres are more or less diffluent, moniliform and in their sub- 
stance show no clear outline of white substance and axis cylin- 
der. Interruptions by granule masses and vacuoles are common. 
In old standing or chronic cases the liquid exudate and granular 
debris have been largely absorbed and the thickening of the 
neuroglia by fibrous neoplasm, has restored the firmness or even 
approximated the part to a condition of sclerosis. 

In case the meninges are involved there is thickening by exud- 
ation into their substance or on their surface, there may be ad- 
hesion between the outer and inner layers of the arachnoid and a 
serous fluid, red, milky or clear, distends the arachnoid or sub- 
arachnoid space. The false membranes, here as elsewhere, are 
usually red if recent, and increase in pallor with age. 



Acute Myelitis in the Dog. Meningo- Myelitis, 165 

Symptoms, These are in the main the same as in the larger 
animals. The early excitement usually takes the form of hyper- 
aesthesia. When lifted, pressed, touched or only approached 
the dog may growl, howl, snap, cringe, cower or tremble, glancing 
up meanwhile with anxious or pleading eyes. When later, this 
gives place to anaesthesia no such interference will draw a re- 
spouse. The motor disorders at the outset are mostly of the 
nature of tremors or twitching of the muscles of the limbs or of 
those parts of the trunk corresponding to the seat of the iesion. 
In exceptional cases spasms or convulsions may be shown. Tras- 
bot records a case of very acute myelitis of the brachial enlarge- 
ment in which there were clonic contractions of the muscles of 
the neck, jaws and eyeballs, and grinding of the teeth, which 
condition lasted for thirty six hours. When this motor excite- 
ment merges into paralysis it usually attacks the hind limbs which 
are extended backward helpless while the animal pulls himself 
forward by his fore limbs. Some such cases are restless and in 
continual movement while others are dull, apathetic and indis- 
posed to move. The precise seat of the paresis or paralysis will 
be determined by the seat of the lesion as in the larger animals. 
Thus paraplegia is most common, less frequently hemiplegia, 
palsy of the fore limb, palsy of a single limb, and monoplegias, 
about in the order named. Palsy of the tail and sphincters im- 
plies a lesion of the lumbar section of the cord and is very 
offensive in the incontinence of urine and faeces especially in long- 
haired subjects. 

Treatment, The abstraction of blood is rarely called for in 
myelitis in the dog. If admissible at all it is in the case of strong, 
vigorous, plethoric animals which have been attacked in connec- 
tion with sudden exposure to cold or accidental concussion, and 
which are presented for treatment at once. Then leeches may 
be applied to the abdomen or inside of the thigh, or the jugular 
may be opened with a lancet. • Usually on the other hand the 
patient is fat, lymphatic, and, if a few days have elapsed, even 
anaemic, while if he has been the victim of an accident the 
shock and prostration would forbid any depressive measures. 

Derivation toward the bowels may be sought by pugative doses 
of calomel or jalap. In case of high fever, cold may be applied 
(in the form of icebags, evaporating lotions or wet cloths) to the 



1 66 Veterinary Medicine. 

tender portiou of the spine. If the attack has followed exposure 
to cold, salicylate of soda may be given, otherwise the bromide of 
potassium or camphor. Acetanilid and other antithermic agents 
may be used with caution. 

With the abatement of the high fever and the supervention of 
paresis, if not before, counterirritants are demanded. 

Owing to the propensity to lick and the danger of absorption, 
poisonous agents are virtually prescribed. Yet MoUer advises 
cantharides, croton oil, mercuric iodide, and oil of mustard, and 
Trasbot restricts the choice to tartar emetic one part to sixteen 
parts of lard. This the latter rubs softly along the spine for sev- 
eral minutes. If the dog is closely watched or muzzled this or the 
mustard or croton oil may be admissible. If otherwise, a long- 
haired dog may be rubbed on the spine with a combination in 
equal parts of strong aqua ammonia and olive oil ; or it may have 
applied for some minutes wet cloths rather hotter than the hands 
can bear ; or a light cauterization may be made with a Paquelin 
cautery. At this stage, too, bitters and phosphate of lime may 
be given. Trasbot has long used with the best results i grain 
doses of neutral, gelatinoid phosphate of lime, repeated two or 
three times a day. Iron may also be restored to, or sulphate of 
zinc. Strychnia and electricity are also of great value as soon 
as the irritability of the spinal centres will allow of their safe em- 
ployment. Massage and gentle exercise are important. 

From the first, attention must be given to obviate the retention 
of urine and faeces, and the strict antisepsis or asepsis of the 
catheter adopted to prevent infective cystitis and nephritis. 

Throughout the disease abundant nourishment of an easily 
digestible quality is demanded. Cleanliness, pure air and general 
comfort must not be forgotton. 



CHRONIC MYELITIS. SCLEROSIS. 

Scqncl to acnte. Result of sprains and spinal injuries. Symptoms : pa- 
resis on exertion, lameness in one or more limtM, knuckling, drcnmdnctive 
movement of feet, uncertain planting, dropping, worse if blinded, phe- 
nomena pmgwim. Lesions : sclerosis of cord ; absorption of ner¥e cells 
and fibres, in gray horns, and columns, superior, lateral and inferior, cord, 
altered in color, unduly firm, in points softening. Stains deeply in CAr- 
mine, lightly in osmic add or hsematozylin. Meninges thickened, nerve 
roots atrophied. Diagnosis : prerious acute myelitis ; later muscular weak- 
ness, and paresis, under exercise : from embolism. Treatment : hopeless if 
advanced ; pr ogres s delayed only. Good hygiene, tonics, open air, gentle 
exerdse, pure water, grooming, succulent pasture, nourishing food, alka- 
lincs, common fait, phosphates. 

Cases of this kind have not been satisfactorily diagnosed, and 
as a mle domestic animals affected with partial paralysis are 
rarely allowed to live in a condition in which they are offensive 
to themselves and owners, a source of constant expense with 
little or no hope of recovery nor profit. Again, in the case of 
the large mammals, the prolonged recumbency and the low grade 
of nutrition in the semi-paralyzed parts, usually entail unhealthy 
sores and septic poisoning which sooner or later prove fatal. It 
is only, therefore, in the slighter cases, in which a fair measure 
of control over the limbs remains, that these cases are likely to 
survive. Trasbot suggests that many cases which pass for lum- 
bar sprains are really chronic myelitis and on careful examination 
will show spinal sclerosis. 

Causes. These are largely speculative, yet doubtless the same 
causes which determine the acute form, will produce the chronic 
when acting with less force and greater persistency . The lesions 
that are left after an acute attack are calculated to keep up a 
measure of vascular and trophic disorder which will be found 
associated with more or less sclerosis. 

Symptoms. In Weber's case in the horse (Recueil de Med. 
Vet., 1884, p. 432) the advance was slow, so that for nearly a 
year the manifestations were not diagnostic. At first there was 
weakness of the hind limbs when worked to fatigue. Perfect 
rest led to improvement, and work, to aggravation which became 
steadily worse and worse. For a length of time the horse main- 
167 



1 68 Veterinary Medicine, 

tained good conditiou, glossy skin, elevated head, alert expres- 
sion, keen sight and hearing, and normal breathing and pulse. 
Standing in the stall there was no abnormal position of the limbs, 
nor evidence of lack of perfect control. 

But when moved all this was changed. He showed first lame- 
ness in the right fore limb and soon in all four members. The 
feet were swung and planted uncertainly, the animal swayed and 
staggered, the limb would knuckle over at the knee or fetlock, 
or bend at the hock, and be recovered with difficulty. After 
going slowly for a few steps he moved with greater freedom 
though still with difficulty, and the trouble was greatly aggra- 
vated when the eyes were blindfolded. Then every step threat- 
ened to precipitate him to the ground. The symptoms were es- 
sentially those of locomotor ataxy. 

The tactile sensibility was unimpaired, the loins had the 
normal sensibility, urination and defecation were natural and the 
appetite remained good. After ten months he showed loss of 
condition, dullness of the special senses, stupor, and a special 
sensitiveness about the head, and resented its handling. 

Lesions, Thirteen months after the commencement of the at- 
tack this horse was destroyed and the cord was found to be 
profoundly altered by fibroid degeneration of the neuroglia and 
absorption of the nerve elements (cells and fibres), the lesions 
afiFecting different portions of the gray horns, and the columns — 
superior, lateral and inferior. The affected portion of the cord 
usually shows in man a grayish, opaque or translucent appear- 
ance, with in some cases a shrunken aspect and undue firmness 
of texture, and at points, centres of softening. If hardened, 
the sclerosed sections take the carmine stain, deeply, but the 
osmic acid or hsematoxylin stain very slightly, contrary to what 
holds in health. In recent cases there is only slight thickening 
of the neuroglia, but when the disease is advanced the trabeculae 
are thick, dense, and firm, and the nerve fibres have largely dis- 
appeared. The coats of the blood vessels adjacent to the sclerosis 
are thickened and their lumen is narrowed. Thickening of the 
meninges is not uncommon, either confined to those covering the 
diseased portion of the cord or extending completely around it. 
Atrophy of the nerve roots is often appreciable by the naked eye. 

Diagnosis. This depends largely on the fact that the condition 



Chronic Myelitis, Sclerosis, 169 

follows an acute attack of myelitis, on the supervention of mus- 
cular weakness and lack of muscular control, whenever the animal 
is exercised to fatigue, the morbid s3rmptoms subsiding promptly 
when he is allowed to rest, the aggravation of these symptoms 
when the patient is blindfolded and a gradual though slow ad- 
vance of the s3rmptoms with the lapse of time. From arteritis 
and embolism it is to be distinguished by the absence of the local 
symptoms of pain and tenderness, and by the absence of pulsation 
in the same artery distal of the obstruction and of improvement 
by the lapse of time or a run at grass. 

Treatment Unless in the very early stages even a partial re- 
covery is not to be looked for. By a run at grass or by gentle 
well regulated exercise the impaired nerves and muscles may be 
educated to a better control for a limited period but the progress 
of the disease is not really arrested and the final issue is likely to 
be ruinous. Even in man, where 90 per cent, of the cases are 
connected with syphilis, the fibroid h3rperplasia (sclerosis) is not 
remedied as gtunmataare, by mercury and iodides. In the soliped, 
where no such specific disease can be charged, the repair of the 
structural changes is no more hopeful. The many different 
methods of treatment in man,— electricity, blisters, firing, stretch- 
ing of the spine, stretching, of the sciatic and crural nerves 
— though inducing transient improvement in many* cases, 
produce no real permanent benefit, and are to be remand- 
ed to the region of psychic inferences which have little or 
no place in the therapeutics of the lower animals. Strych- 
nia, veratrin and other spinal stimulants are of little per- 
manent value. A general hygienic and corroborative treatment 
may be used with the view of retarding the progress of the dis- 
ease rather than of curing it. Open air exercise, sunshine, suc- 
culent pasturage, an ample supply of pure water, and active 
grooming are valuable. Nourishing food is all important. 
Lecithin or the hypodermic injection of spermin or other rich 
albuminous animal product is useful. A course of bicarbonate of 
soda and carbonate of iron with or without bitters may be tried. 
When the animal must be kept on dry winter food, he should 
have free access to common salt and water. This favors at once 
absorption, assimilation, and elimination, and by fostering nu- 
trition and the removal of waste matters, it contributes to keep 



170 Veterinary Medicine, 

the disease in abeyance. Phosphoric acid and the various phos- 
phates have been largely used and largely rejected, their main 
value being in the tonic effect on the spinal centres. Trasbot 
especially recommends the neutral gelatinoid phosphate of lime 
as having proved especially valuable in his hands. He gave 
from I grain upward to dogs twice a day. 



ARTERITIS (THROMBOSIS, EMBOLISM) OF THE 
SPINAL CORD AND MEMBRANES. 

Conditions of spinal circulation favorable to embolism and microbian in- 
vasion. Slow currents. Blood stasis. Free anastomosis a compensation. 
Symptoms. Treatment. 

Facts are wanting with regard to these lesions in the domestic 
animals, but anatomical, physiological and pathological consider- 
ation are strongly suggestive of their occurrence. The vascular 
network of the spinal cord favors a tardy circulation, and this in 
turn is favorable to the arrest of solid bodies and the delay, pro- 
liferation and colonization of microbes. The median spinal artery 
receives a supply of blood by two trunks, right and left, entering 
by the intervertebral foramina at each intervertebral articulation. 
It has not, therefore, one continuous, equable, onward flow, but 
rather numerous independent currents corresponding to the enter- 
ing vessels, and with intervening eddies or areas of comparative 
stagnation. The nervous material of the cord admits no large 
arteries but only capillary trunks which anastomose freely in its 
substance. This would seem to entail a sluggish flow, which 
would favor microbian arrest and colonization, even if the small 
size of the vessels serves to shut out clots of any material size. 
Finally the abundant venous plexus, and especially the two lateral 
venous sinuses, communicating freely with each other and^ 
through each intervertebral foramen, with the extra spinal veins 
determine a similar tardy flow that should be favorable to morbid 
processes. If we pass back of these vessels, we find the posterior 
aorta to be at once the largest and the most direct channel for the 
entrance of emboli coming from the left heart or limgs. This 
danger is counteracted in greater part by the fact that the greater 



ArteriHs of the Spinal Cord and Membranes. 171 

part of this blood passes into the large vessels which supply the 
liver, spleen, kidneys, stomach, bowels, and hind limbs, and 
while embolism is well known in these parts it has not been 
demonstrated as yet in the spinal cord. The toxins produced in 
infectious diseases and circulated in the blood can often lead to 
destruction of the endothelium, and inflammation of the deeper 
structures. In this way any circulating microbes find a ready in- 
fection atrium. Hektoen seems to have demonstrated this in the 
case of tubercular meningitis. By pressure of the neoplasm on the 
vessel or by fibroid thickening and contraction of the walls of the 
vessel, the subsidiary cord is denied its full supply, and degenera- 
tion of the nervous substance is invited. In the human subject 
degeneration of the cord has been shown to follow the line of 
such diseased arteries. Thrombosis follows in every case in 
which the serous coat is involved, and embolism can easily occur 
from clots small enough to enter the capillary vessels. I^amy's 
experiment of blocking the small arteries with inert powder^ 
shows that this will give rise to foci of hemorrhagic softening, 
which commence in the gray substance. The blocking, how- 
ever, must be multiple to produce any material eflFect, as the free 
anastomosis of the spinal capillaries otherwise secures an abund- 
ant blood supply to adjacent parts. In case of an infective em- 
bolism the disease will advance even if the obstruction is single. 
The general symptoms of these conditions would depend on the 
exact seat of the lesion, and treatment would have to proceed on 
general principles, the object being to check the inflammatory 
conditions, and trust to the ins medecatrix natures in connection 
with rest and good hygienic conditions. 



HEMORRHAGES INTO THE SPINAI. MEMBRANES 

Meningeal Spinal Apoplexy. Hi^MATORRACHis. 2. Hem- 
orrhage INTO THE Spinal Cord. Spinal Apoplexy. 

H-flSMATOMYELIA. 

Definition. Causes : violent exertion, blows, falls, morbid blood, frac- 
nres, caries, tumors, tubercle, aneurisms. Lesions : Clot between or outside 
membranes in meningeal haemorrhage, in gray matter and even in white in 
myelon bleeding. Cord bulges. If survives, nervous matter absorbed. 
Symptoms : Sudden stiffness or palsy of given areas ; spasms more common 
in meningeal extravasation. Rapid muscular wasting. No fever at first. 
Treatment : cold to part ; slings ; atropia, ergot, lead acetate. Later as 
for myelitis. Large clot may warrant surgical interference. 

In the first of these forms the bleeding takes place between the 
arachnoid and the two contiguous membranes — ^pia and dura, or 
outside the dura. In the second it takes place into the substance 
of the cord though it may encroach on the pia mater. Both con- 
ditions have been attributed to violent muscular eflForts or con- 
tractions as in draught, racing, fighting, leaping, tetanic con- 
vulsions, also to blows on the back, or falls from a height. Mor- 
bid states of the blood in which there is a hemorrhagic tendency 
(scurvy, purpura, haemophilia, anthrax) may be contributory 
causes. Spinal fractures, aneurisms, caries, tumors and tubercle 
may be additional causes. 

Lesions, In miningeal bleeding the clot is found outside the 
dura, or between the dura and arachnoid which may or may not 
be ruptured. A clot on the pia mater may press seriously on the 
cord or may cause rupture of the arachnoid. In hemorrhage 
of the cord, the effusion usually begins in the gray matter, though 
it may extend far into the white. It may be circumscribed to 
half an inch in diameter or affect almost the entire length of, 
the cord. The cord may be distinctly enlarged at the point of 
effusion, and in exceptional cases the blood may have broken 
through to the membranes. If the patient survives, absorption 
and degenerations of the cord are inevitable. 

Symptoms, In both forms there is a sudden attack, with 
172 



spina Bifida, 173 

stifiFness or paralysis of given muscles and without hyperthermia. 
Rigidity and spasms of the muscles are more characteristic of 
meningeal hemorrhage, and early paralysis of the spinal. An 
early hypersesthesia is also most significant of an efiPusion in 
the cord, Rapid muscular atrophy is also characteristic of 
this. The two conditions resemble meningitis and myelitis but 
come on much more suddenly and are unattended by fever. 

Treatment, Such cases are not hopeful. Cold to the a£Fected 
part of the spine, keeping the patient in slings to solicit the good 
e£Fect of gravitation, and giving ergot or lead acetate internally 
are among the first indications. Later, the treatment would be 
practically the same as for meningitis or myelitis. In case of 
complete paralysis from a sudden formation of a large clot, it 
has even been advised to cut down on the seat of the injury and 
evacuate the blood, using antiseptic precautions. 



SPINA BIFIDA. 



This is an elastic swelling consisting of the -spinal meninges 
enclosing a liquid, and in some cases the spinal cord as well, 
and protruding between the unclosed laminae of the verte- 
bral rings, usually in the region of the sacrum or loins. It is 
essentially an arrest of development on the part of the vertebrae 
and enveloping muscles and skin, and an extension of the cord 
and efiPusion of the meningeal and central spinal liquids, in the 
absence of their bony and muscular support. Hydrocephalus is 
no uncommon complication. 

The diagnosis may be based on the presence of an elastic, some- 
what transparent tumor, projecting from the vertebral spines, at 
birth.. , If it contains a segment of the cord it is usually flattened, 
depressed on the summit and often associated with paralysis. 

As occurring in the lower animals this need not be treated. In 
man, careful antisepsis and evacuation followed by injection of a 
solution of iodine 10 grs., iodide of potassium 30 grs., and glyce- 
rine I oz., have, in favorable cases, secured obliteration of the 
sac, but even then the recovery has rarely been complete and 
permanent. Paralysis and death have usually supervened. 



X 



SPINAL CARIES. TUBERCULAR OR OTHER INFEC- 
TIVE DISEASE OF THE VERTEBRAE. 

Spinal caries in old horses, sprains, fractures, infections ; caries often 
confined to articulating processes : anatomical form : Ozoido-atloid caries 
from poll evil, concussions, fights, rachitis. Tubercle of bone and interver- 
tebral cartilage in cattle. Symptoms : distortion, stiffness, rigidity : stands 
day and night, sensory and motor paralysis: localization of lesion ; dyspnoea; 
spastic palsy back of lesion ; effect on tail, sphincters. Diagnosis : progres- 
sive tenderness and stiffness of spine, distortion, localized exaltation or de- 
pression of nervous function, osteoporosis, rachitis, caries, tubercle, mela^ 
noma, abscess, infectious disease. Treatment : Sling in narrow stall, good 
food, pure air, sunshine, tonics, phosphates. 

As seen in the human subject spinal caries is usually tubercular 
and is known as ' ' Potfs disease. ' * As seen in old horses it appears 
to be rather a result of other infections, especially purulent, and 
may have started in connection with traumatics or mechanical 
injuries to the bones and ligaments. In such cases I have seen it 
repeatedly in hollow backed horses in which the line of the spine 
descended abruptly and extremely from the withers and rose 
again to the sacrum. The distortion was so great that the back 
appeared as if it could barely sustain the weight of the animal 
and yet the patients were kept at work and proved useful for 
light driving. Post mortem examination showed extensive caries 
and suppuration of the vertebral bodies, confined, however, to one 
or two segments as if due to a mechanical lesion. In the region 
of the loins it is much more likely to affect the articulations of 
the vertebral rings, because of the manner in which these are 
wedged into each other when the spine is pressed downward. 
In the neck where the normal movement is so much freer such 
injuries are much less common. Caries affecting the articular 
surfaces of the axoido — atloid joint is by no means uncommon. 
It may follow poll evil, or injuries sustained when a horse runs 
against a wall, or in the fights of bulls or rams. Disease of the 
vertebrae may be of the nature of rachitis occurring in this case 
during life. 

In cattle the disease is liable to be tubercular in which case, not 
only is the bone invaded but the morbid process extends to the 
174 



spinal Cartes, InfecHve Diseases of the Vertehne, 175 

intervertebral cartilage and projecting, presses on the spinal 
meninges and cord. It may even encircle the entire spinal cavity 
and strangle the cord. If the pus should extend downward it 
may form abscess under the spine, and rupture into an internal 
cavity or externally. 

Symptoms. Injuries and disease of the vertebrae may last for a 
length of time without implicating the spinal cord or nerves. 
They may then cause only distortion, with stiffness or ridigity of 
the spinal column. When; however, the displacement of the in- 
jured, carious or tubercular bones, the distension of the abscess 
or the increase of the hyperplasia leads to pressure on the 
nerve roots, the meninges or cord, nervous S3rmptoms are like- 
ly to be developed. Compression of the nerve roots — sensory 
or motor — ^may cause sensory or motor paralysis or both, 
limited to particular areas the outline of which will point to 
the precise seat of the lesion. If in the recti of the head and 
other muscles of the neck, it points to the anterior cervical 
vertebrae. If in the fore limbs, it points to the posterior bones 
of the neck. The implication of the diaphragm would in- 
criminate the fourth and fifth cervical vertebrae. If in the 
crural muscles or those of the quarter and thigh, the lumbar 
vertebrae must be looked to. The implication of the nerves of 
the back, while impairing the functions of the intercostal and 
abdominal muscles, produce less marked symptoms than when 
the limbs are involved. 

When the disease extends deeper so as to implicate the men- 
inges and especially the cord, there is evidence of impairment 
or interruption of conduction in the cord in addition to the 
simple involving of the nerves that emerge at that point. Thus 
.serious disease or pressure on the cervical part of the cord in 
front of the fourth vertebra will make respiration difficult or 
impossible and speedy asphyxia may ensue. The paralysis of 
all parts behind the lesion is overlooked, in view of the fatal 
nature of the paralysis of the intercostals and diaphragm. If 
the interruption of conduction is incomplete there may be 
spastic paralysis and hyperaesthesia in the limbs and trunk back 
of the lesion. 

If the dorsal cord is involved so as to render conduction im- 
perfect there will be at first imperfect control of parts posterior to 



176 Veterinary Medicine, 

the lesion, and when still further implicated, flacx:id or spastic 
paralysis, especially of the hind limbs and tail. When it impli- 
cates the lumbar region in addition to the paralysis named for 
the dorsal, there will be incontinence of urine and even relaxa- 
tion of the anal sphincter. In a case of acute tuberculosis in a 
cow, supervening on an ancient tuberculous lesion, as seen by 
the author, there were imperfect control of the hind limbs and un- 
certain gait, with tenderness of the dorsal region as if the animal 
had sprain of the back. 

Diagnosis of these cases of vertebral disease may not always 
be possible in the early stages, yet the symptoms of progressive 
tenderness and stiffness in the region of the spine, the distortion 
in some instances of the spinal column, the subsequent appear- 
ance of localized motor and sensory symptoms, and later still the 
spasms or spastic paralysis in all parts behind the seat of the 
lesion, will be strongly suggestive of such a disease. When in- 
dications exist of osteoporosis, rachitis, or tuberculosis, of caries, 
abscess, or infectious lesions of the cervical or dorsal spinal 
region, the inference is still stronger. Then if reaction occurs 
under the tuberculin test, or if the urine contains an excess of 
phosphates in the herbivora. the case may be diagnosed with 
certainty. 

Treatment, This will rarely be admissible on account of the 
expense and uncertainty of result. Some meat animals may 
be killed for food. If otherwise, keep in narrow stall where the 
animal cannot turn even the head, feed from moderate level to 
avoid movement of the spine by the upward and downward 
movements of the head. Gentle brushing is useful as a means 
of cleanliness, and of toning up the muscular system. Nourish- 
ing food of an easily digestible kind is essential, and pure air and 
sunshine are important auxiliaries. A course of cod liver oil 
with bitters may be given to improve the general health, cal- 
cium sulphide may be tried in case of suppurative caries, and 
calcium phosphate will usually be desirable to improve the nutri- 
tion and consistency of the osseous system. In case of a valued 
patient which it is desirable to preserve for reasons of sentiment 
or affection, or for breeding purposes, one might be warranted in- 
continuing a long and expensive course of treatment, but in the 
regular run of cases considerations of humanity and economy 
would counsel the prompt destruction of the animal. 



SLOW COMPRESSION OF SPINAL CORD. PARALYSIS. 

Causes : Caries, vertebral diseases and lesions, neoplasms, actinomycosis, 
tnbercle, abscess, organizing exndates, parasites. Melanoma, cholesteatoma, 
sarcoma, papilloma, lipoma, f(1ioma, chrondroma. Symptoms : advance 
insensibly, or by sndden leap with exudate, spasm, paresis, transverse, senses 
clear, muscular atrophy, advance from behind forward. Cervical, dorsal, 
' lumbar lesions. Bladder, sphincters, tail. Symptoms increased by move- 
ment. Treatment : according to le5ion. Tumors, hopeless. Blood clots. 
Actinomycosis. Analgesics. Electricity. 

Causes, Slowly progressive compression of the cord has been 
already noted as resulting from caries and other diseases of the 
vertebrae. It remains to notice such as result from the growth 
of tumors and other neoplasms in the spinal canal. In the horse 
these are commonly melanoma (in white horses), sarcoma, en- 
cephaloid, papilloma, cholesteatoma, and osteoma ; in cattle, 
beside tubercle and actinomycosis, have been found sarcoma, 
lipoma, osteoma and glioma ; and in dogs sarcoma and chon- 
dro-sarcoma. Chronic abscesses may be met with in all animals 
determining the same class of symptoms by slow pressure. In 
the same manner exudates in process of organization contract, 
and are liable to compress the myelon. Cadeac draws attention 
to a calcic degeneration of exudates in the dura mater of the dog, 
(ossifying pachymeningitis), and of ossification of the interver- 
tebrae cartilages with vegetations on their surfaces. Parasites 
also exercise a growing pressure, especially echinococcus, in cat- 
tle cysticercus mediocanellata, in sheep and dogs coenurus, and 
in pigs and dogs cysticercus cellulosa. 

Melanoma. In gray and white horses, with disseminated 
melanosis, the spinal canal is often involved, the pigmentary sar- 
coma appearing in small formations and sometimes large enough 
to determine injurious pressure. In the early stages these may 
cause stiffiness and lameness referable to particular muscles or 
groups, varying in situation, even as to the limbs affected, at 
successive dates, and finally merging into paraplegia. 

Cholesteatoma is less common than in the encephalon, yet 
one is reported by Drexler as attached to pia mater and pos- 
sessed of great firmness, crisply crackling under the knife. It 
12 177 



178 Veterinary Medicine, 

doubtless secures accretions under meningeal exudates like those 
of the choroid plexus. 

Sarcoma and encephaloid are usually found in connection 
with the dura mater, and of small size, but numerous. They 
often surround the roots of the spinal nerves, and here as on the 
cord exert sufficient pressure to impair nervous function. 

Papilloma has been found connected with the pia mater and 
of marked vascularity. The author has found one in the ewe in 
a case of the neurasthenia of advanced gestation. 

Lipoma is also rare. Osseous growths are common, being 
favored by sprains and injuries. All show a marked predilection 
for the lumbar and last dorsal vertebrae. This may be partly ex- 
plained by the liability to injury and to disease invasion through 
the interlocking of the joint surfaces of the rings. Osteophytes 
growing from the intervertebral cartilage are common in the dor- 
sal region as well. 

Glioma has been found in cattle, occupying the substance of 
the cord itself and growing to the size of a hen's t%% or even of 
the closed fist. The cord is gradually atrophied and paraplegia is 
inevitable. 

Chrondro-sarcoma has been found growing from the inter- 
vertebral fibro cartilage of dogs. 

Tne Symptoms may be deferred for a length of time on account 
of the accommodation of the myelon to the slowly increasing 
pressure. When they do become manifest, it is usually at first by 
insensible gradations so that for a time their existence is question- 
able. Yet a case will sometimes reach a sudden climax, by reason 
of a blood extravasation or inflammatory exudate, and the signs 
of sudden pressure or acute myelitis or meningitis supervene. In 
the absence of sudden access of trouble, the symptoms are those 
of a slow increase of motor troubles (local paresis, paralysis, 
paraplegia), or sensory ( hyperaesthesia, anaesthesia). Spasms 
may occur early or even later in the disease. From disorder due 
to cerebral lesions the morbid phenomena are distinguished by 
being paraplegic rather than hemiplegic ; sensori-motor rather than 
sensory or motor ; local rather than general ; with intelligence 
and special senses clear, rather than dull or abolished ; associated 
with marked muscular atrophy in the afiFected parts ; advancing 
from behind forward rather than uniform throughout the body. 



Slaw Compression of Spinal Cord. Paralysis, 179 

The area of nervous disorder points more or less clearly to the 
seat of the lesion. Early implication of the fore limbs, and then 
later of the hind, suggests lesion of the cervical region. Dyspncea 
tumultuous heart action, or vertigo may coincide. Tardy move- 
ments of the hind limbs, imperfect balancing, dragging, swaying, 
knuckling, involuntary flexions of stifle or hock, flexor con- 
tractions, standing on toe, cramps, paraplegia, indicate lesion 'in 
the dorsal or lumbar region. There may be palsy of the rectum, 
anus, bladder, sphincter vesicae, penis, and vulva. Paralysis or 
other nervous disorder of the tail and sphincters ani and vesicae, 
without implication of the hind limbs or quarters, may bespeak 
lesion in the terminal end of the spinal cord. 

With paralysis of the bladder the penis may be pendent out of 
the sheath, or being retained within it, the urine may dribble 
constantly into and from that cavity, and the vulva may be soft 
and flaccid. When the anus is involved, the adjacent part of 
the rectum usually participates becoming overloaded, the sphincter 
is soft and lax and allows a constant oozing, and the exposure of 
the mucosa. The paralytic tail hangs between the thighs, limp 
and flaccid, and becomes saturated with manure and in females 
with urine. 

Even in the earlier stages the symptoms are usually greatly 
aggravated by compulsory movements like turning in a circle, 
walking up hill, or (in dogs) up a stair, and the arched back, the 
pendent head, and hesitating planting of the foot suggests walk- 
ing on pins. For a more exact localization of the lesion the 
reader may consult the table indicating the functions of the 
different parts of the spinal cord. The early fatigue under exer- 
cise grows as in other progressive spinal lesions. 

Treatment, In most cases this is hopeless. Tumors, bony and 
calcic growths, tubercles, degenerations and absorption of nervous 
tissue are practically beyond remedy. A blood extravasation 
may be largely absorbed, leaving only the permanent changes in 
the nervous tissue. In this, time is the main element. Actino- 
mycosis may sometimes be successfully met by a course of potas- 
sium iodide, when, if the nervous lesions are slight, a fair re- 
covery may be secured. In the majority of cases, however, the 
practitioner is limited to measures for palliation of suffering by 
atropia, chloral, phenacetin, etc., or by nerve stimulants like 



i8o Veterinary Medicine. 

nux in small doses, or by weak currents of electricity. In meat 
producing animals, it is often the best course to fatten rapidly, 
or to turn over at once to the butcher. 



DILATATION OF THE CENTRAL CANAL OF THE 
SPINAL CORD. SYRINGOMYELIA. 

This means literally a cavity in the spinal cord but is applied 
to cavities formed by dilatation of the central spinal canal, or by 
an excavation in the nervous tissue immediately adjacent and 
usually communicating with a dilated segment of the canal. In 
man it is usually the result of an active proliferation of the 
epithelial cells of the canal, blocking the same, or extending into 
the adjacent nervous tissue in the form of a glioma. In difiFerent 
cases in dogs it occurred as the result of pressure. It has been 
seen in dogs, cats and Guinea pigs, as a casual lesion and as the 
result of experiment. 

In a case reported by Lienaux it extended for practically the 
whole length of the cord, varying in form and size at different 
points. In the lumbar portion it was only slightly dilated, in the 
dorsal it was very irregular with prolongations into the gray mat- 
ter, toward the cervical enlargement, its transverse section re- 
sembled an inverted V, and in the anterior cervical part it was 
unevenly rounded. Notable changes were cell proliferation and 
subsequent degeneration with the formation of cavities, thicken- 
ing of the neuroglia, and compression and even obliteration of 
the vessels with circumscribed areas of necrosis, terminating also 
in cavity formation. 

Symptoms. These vary with the nervous structures invaded, 
atrophied or destroyed. Invasion of the anterior horns of gray 
matter, causes trembling and muscular wasting. The implication 
of the superior horns determines more or less marked anaesthesia. 
Hyperaesthesia, spasms, paresis and paraplegia are also seen but 
no symptom nor group of symptoms is diagnostic of the exact 
lesion. 

Treatment is manifestly hopeless. 



NEURASTHENIA IN PREGNANT EWES. 

Canses : inactmty, lowered miuciilar and nenrons tone, twin pregnancy, 
approach of parturition , dry (doyer ha j) ration , concurrent diieanfa Symp- 
toms : moping, anorexia, depreaaion, stupor, blindness, paresis, lethargy. 
Prevention : open air life, ezerdse, high muscular condition, avoidance of 
debilitating and relaxing conditions. Treatment : hygienic, nerve tonics, 
attend to concurrent diseases. 

Neurasthenia has been defined as an incompetency of the 
nervous system, leading to early fatigue, and inability to recuper- 
ate from the prostrate condition. Pending a better knowledge of 
the affection. I have given this name to an asthenic affection seen 
in pregnant ewes when nearing the completion of the period of 
gestation. 

Causes. In a large number of cases I have found several con- 
ditions so constant, not to say invariable, that they seem to de- 
serve special attention in the list of causes : 

1st. Enforced inactivity. In every instance that has come 
under my notice the ewes have been confined for several months 
to a bam or at most a confined yard so that exercise became im- 
possible. The muscular system was flabby and soft, although as 
a rule there was abundance of fat, and the number of red globules 
did not vary much from the normal. In an animal that is natur- 
ally so active, and so accustomed to outdoor life the reduction of 
tone and vigor is to be expected. The same evil shows in other 
directions, thus after a 'snowy winter and close confinement the 
crop of lambs will sometimes perish of goitre without exception, 
while in subsequent years, with enforced exercise of the ewes, 
practically all escape. 

2d. Twin lambs have been found in the womb of almost every 
case examined. The extra drain upon the system, and the de- 
pressing action of the load on an atonic ewe together with the 
symptomatic irritation are to be noted. 

3d. The near approach of the completion of gestation, the 

cumulative effect of a long pregnancy , and perhaps the absorption of 

metabolic products from the f cetal membranes in course of prepar- 

tion for detachment, and of leucomaines from the physiologically 

181 



1 82 Veterinary Medicine, 

active or developing mammae, doubtless have a prostrating influ- 
ence on the susceptible nervous system. 

4th, All had been fed on clover hay either as an exclusive diet 
or as part of their ration. This is sufficiently nutritive, as testi- 
fied by the fat condition of the patients, but it may be that it was 
too nitrogenous for such an inactive life. Again the clover hay 
usually aboiiiids in cryptogams and bacteria and their products, 
which may have contributed somewhat to the asthenia. 

5th. Concurrent diseases, in individual cases or flocks, mani- 
festly contributed to the general loss of nervous power. In some 
the bowels were studded with the nodules of the oesophagostoma, 
in others oestrus larvse had extensively invaded the nasal sinuses,- 
one had congestion of the mucosa of the small intestines, some 
had congestion and fatty degeneration of the liver, others had 
fatty kidneys, and one had a papilloma pressing on the spinal 
cord. Manifestly diseases and degenerations of various kinds 
would still further undermine nervous energy and add to the 
atony. 

Cold and heat did not seem to dominate, as most were kept in 
warm bams, and wore heavy winter fleeces, while one clipped 
early in December, and kept in an atmosphere 40® to 55°, was 
attacked in the second week of January. 

As this experience was had in a goitre district it may become a 
question whether the poison of this disease was a causative 
factor. Goitre was not a prominent feature in either ewes or 
lambs. 

Symptoms, Variable. The most prominent are, leaving the 
flock, moping alone, grinding the teeth, drooping and trembling 
of head and ears, temperature normal or subnormal (100.5®), 
respiration 24, pulse 80, feeds and ruminates sparingly, bowels 
normal, buccal mucosa pale, conjunctiva hyperaemic, in some 
cases stupor and partial blindness, the animal walking against 
racks or fences, walk is slow and unsteady, the muscles feel soft 
and flabby, the abdomen may be full, but its walls are quite 
flaccid so that the lambs can be easily felt. As the disease ad- 
vances all symptoms are aggravated, food is no longer taken, 
rumination ceases, the ewe remains recumbent, cannot be made 
to rise, and when lifted and carried makes no struggle. After 
24 hours of this helpless condition death supervenes. In some 



Neuritis, Perineuritis, 183 

instances labor pains have come on and the ewe has perished in 
a vain effort at delivery. Illness lasted about a week. 

Prominent lesions have been noted under causes. It need only 
be added that no notable difference from the normal was found 
in making a count of the red globules, and the size of the in- 
dividual globule was normal or only perceptibly smaller as is to 
be expected in a dense plasma. In different cases there was 
found congestion of the abomasum, small intestine, liver and 
brain. 

Prevention, The most important measure is to maintain a 
strong, well-developed muscular system, and a vigorous nervous 
tone by a sufficiency of out door exercise during the winter 
months. Half a mile or a mile at least should be given daily to 
the breeding ewes, no matter what the attendant difficulties. If 
clover hay is musty it should be replaced in whole or in part by 
another kind. Parasites and other diseases which tend to lower 
the general tone should be appropriately treated. 

Treatment, When once established, the disease has not been 
successfully treated. Nerve tonics are indicated. 



NEURITIS. PERINEURITIS. 

Definition. Causes : traum&t, poke, stanchions, collar, yoke, interfering, 
neurectomy, fractures, tumors, callus, rheumatism, gout, violent over-dis- 
tension. Lesions : nerve sheath red, swollen, exudate, leucocytes in excess, 
fibroid thickening, nerve atrophy, degeneration, axis granular, myelin in 
oily globules, peripheral extension. Muscular degeneration and atrophy. 
Symptoms : tenderness, swelling, muscular atony, wasting, spasms, twitch- 
ing, decreased excitability, paralysis, in section swelling on proximsl end. 
Prognosis : disability for weeks, months or year ; response to electric cur- 
rent, operability of tumors, curability of rheumatism or gout, hopeful con- 
ditions ; long standing degeneration, etc., unpromising. Treatment : rest, 
soothe, anodynes, splint with soft pad, essential oils, lead and opium lotion, 
ice, snow ; derivatives ; laxatives ; diuretics, anti-rheumatics. Faradisation. 

Definition, Inflammation of a nerve leading to paralysis of 
the parts to which it is distributed. 

Causes, Traumatism is the most common factor. Among the 
common examples are injury of the seventh nerve above the 



184 Veterinary Medicine, 

angle of the lower jaw, by a poke worn in pasture by the horse, 
or by stanchions in the cow. Hogs may sufiFer from blows of the 
triangular neck gear worn to prevent them from breaking through 
fences. Blows by the yoke, incised and contused wounds implicat- 
ing the nerve, such as neurectomy, and the blows received in in- 
terfering, and compression by tumors or bony growths, are 
familiar examples. Fractures with displacement, notably those 
of the sacrum and proximal end of the coccyx with caudal paraly- 
sis, are not uncommon. In fractures of the limbs the pressure 
upon or wounding of a nerve. Again, the callus on the seat of 
fracture may induce neuritis by pressure as may also the projec- 
tion of the end of a bone in luxation. Rheumatism affecting the 
nerve sheaths and, in birds and swine, gout, are additional 
factors. Violent overdistension, and even chronic muscular 
spasm, are quoted as causes. 

Lesions. The early changes are mainly in the connective tissue 
sheath, which becomes h5rperaemic, red and swollen, with a gela- 
tinoid exudate and a great multiplication of leucocytes. Later, 
the interfibrillar connective tissue is involved and the nervous 
substance proper undergoes hyperaemia and degeneration. The 
axis cylinder undergoes granular degeneration and the myelin 
breaks up into oil-like globules. The lesions are at first limited 
in extent, though there may be more than one focus, and the re- 
sulting degeneration of the nervous filaments advances toward 
the periphery in accordance with Waller's law by which disease 
changes proceed rapidly in parts cut off from their trophic cells. 

The muscles supplied by the inflamed nerves also rapidly 
degenerate. The fibres shrink in size, and lose their striated 
appearance, becoming distinctly granular, and pale. Round cells 
are formed in excess in the sarcolemma and muscular fibre, and if 
the morbid condition persists there is fibroid degeneration, cir- 
rhosis and contraction. 

Symptoms, In the absence of the subjective element of pain, 
which is the most constant symptom in man, we must rely mainly 
on the exquisite tenderness on pressure along the line of the 
nerve, but localized at some particular point, on the swelling at 
such tender point and on the loss of muscular power or even of 
sensation in the tissues corresponding to its peripheral distribu- 
tion. The muscles may be hypersensitive and are usually flaccid 



Neuritis, Perineuritis 185 

if not from actual paralysis, still from the pain which attends on 
their contraction. In some cases they are the seat of clonic 
spasms or twitching. Under a current of electricity they show a 
decreased irritability which bears a direct relation to the grade of 
degeneration which has occurred in the nerve fibres. In cases of 
deep-seated neuritis paralysis may be the only appreciable symp- 
tom. In traumatic injuries like bruises of the seventh nerve 
or fracture of the sacrum the local swelling and tenderness are 
marked initial symptoms, upon which supervene the paralysis and 
atrophy of the muscles cut off from full innervation. In neurec- 
tomy the tender swelling in the stump which is still in connection 
with the nerve centre may amount to a distinct neuroma, while 
the peripheral and detatched portion of the nerve steadily loses its 
irritability as shown by electric stimulus. 

Prognosis. This will depend on the nature of the lesions. A 
single transverse section of a nerve, without loss of substance may 
be repaired in a few months, while with loss or degeneration of a 
considerable part of its substance it may maintain a paralysis for 
years or even permanently. Lesions due to slight bruises may 
recover in a few weeks, while the more severe ones will persist for 
months or years. The response to electric stimulus distal of the 
lesions, is a guarantee of the absence of degeneration and a feature 
hopeful of recovery. Pressure by bony displacement or neoplasia 
must be done away with as the first condition of improvement in 
such cases. Rheumatic and gouty cases will persist until these 
constitutional infirmities are corrected. 

If the neuritis and paralysis have lasted for any length of time, 
the degeneration of the muscles will keep up a degree of muscular 
weakness (and if in the limbs lameness) after the repair of the 
nerve has been completed. 

Treatment. Rest is the first consideration accompanied by 
soothing and anodyne application to the inflamed nerve. When 
neuritis exists in a limb a softly padded splint may be useful at 
first. The skin over the inflamed nerve may be rubbed by one 
or a combination of the anodyne essential oils, (oil of cajeput, oil 
of peppermint, oil of lavender). If the pain and tenderness are 
extreme, a bag of ice or snow may give relief and should be kept 
applied for a length of time. Or hot fomentations with a lotion 
of lead and opium may be preferred especially in rheumatic cases. 



1 86 Veterinary Medicine. 

If blisters seem to be called for, aqua ammonia and oil of turpen- 
tine may be added to the essential oils, or muriatic acid may be 
applied with a glass rod in points along the line of nerve. A 
laxative of Epsom or Glauber salts will often prove of great value 
at the outset and may be followed by diuretic doses of potassium 
iodide, potassium nitrate or acetate, and in rheumatic cases 
sodium salicylate. In these last forms, as also in gout, the car- 
bonates and acetates of the alkalies, colchicum, and salicylates are 
especially to be persisted with. In these, too, rubefacients and 
blisters are often of essential value and may be repeated again 
and again. 

Faradism is of little account during the active stage of neuritis 
excepting as a test of the progress and extent of the degeneration, 
but when inflammation has subsided nothing contributes more ta 
the restoration of the tone and healthy nutrition of both nerve 
and muscle. The current is to be sent along the line of the pare- 
tic nerve and muscles for ten or fifteen minutes at a time and not 
less than once a day. 



NEURALGIA. 



Intermittent or remittent pains, in line of nerve without inflammation, or 
other structural lesion. Diagnosis : lameness, stiffness of particular mus- 
cles having a common nerve. Unnatural position habitual. Pain of inflam- 
mation and of neuralgia. No functional change. Rheumatism. Tumors. 
Causes : lead, rheumatism, gout, auto-poisons, cold, aosemia, reflex. Facial 
neuralgia, occipitocervical, dorso-intercostal, lumbo-abdominal, sciatic 
Treatment: elimination, of lead, etc. ; intestinal antiseptics, tonics, hot 
water, anodynes, arsenic 

This is characterized by pain paroxysmal,, intermittent or re- 
mittent situated in the course of given nerves. It must be a pure 
neurosis and unaccompanied by any specific structural lesions like 
inflammation, degeneration, atrophy, hypertrophy, tumor or the 
like. It is therefore manifested subjectively and cannot be easily- 
identified in the lower animals. Nevertheless, Lafosse, Zundel, 
Gen^e, and others have recorded cases, their conclusion being de- 
ducedirom symptoms which were held to indicate nervous suffer- 



Neuralgia. 187 

ing in the absence of any structural lesion whatever. A priori 
one can with difficulty escape the con\nction that neuralgia must 
exist in the lower animals as in man, and the only drawback to its 
recognition is the difficulty of diagnosis. 

The first step in such diagnosis must usually be the presence of 
lameness, stiffness or indisposition to free movement of some par- 
ticular muscle or group of muscles deriving their innervation from 
a particular nerve. Or there may be a particular position habitu- 
ally assumed such as semi-dosed eyelids, drawn back ears, laterally 
inclined neck which strongly suggests nervous suffering. Next, 
there must be the exclusion of any appreciable structural cause 
and especially of inflammation. The three prominent features of 
the pain of inflammation is that it is aggravated by pressure, it is 
heightened by movement, and it is accompanied by some decided 
alteration of the function of the part. If there are at the same 
time exudation and swelling, inflammation is all the more certainly 
indicated. In a neuralgic pain on the contrary pressure does not 
increase the pain : it may even alleviate it : movement of the part 
may be rather satisfactory to the patient than painful ; and the 
disturbance of function, contractile, secretory, trophic, is not per- 
ceptible. There is no local exudation nor swelling to account for 
the nervous disorder. 

The liability to confound the affection with a neuritis more 
centrally situated, but the pain of which is referred to the peri- 
phery of the nerve, is to be obviated by a tracing of the nerve 
along its course to the nerve centre so as to identify any centre of 
tenderness, and also by the implication of all the peripheral 
branches coming off ectal of that point. 

Again, rheumatism may be easily confounded with neuralgia, 
but here the affected nerve and muscle and even the skin over it 
is liable to be very tender to the touch or pinch, and if at all 
acute some hyperthermia is present. Like rheumatism, neuralgia 
shows a tendenc}' to shift from place to place. 

Pains due to pressure on the nerves by tumors, aneurisms, and 
other swellings, are constant, whereas neuralgic pains are marked 
by remissions and aggravations and even by intervals of complete 
relief. 

Causes. The toxic neuralgias are illustrated by chronic lead 
poisoning, in which, in man, there are wandering pains like those 



1 88 Veterinary Medicifie, 

of rheumatism, and in the lower animals muscular stiffness and 
contractions which suggest a similar condition. In man, too, 
gout is a common factor, and in pigs and birds in which this con- 
dition exists, stiffness and evidence of suffering may well be at 
times attributed to a similar cause. How many other forms of 
chronic metallic poisoning and poisoning by morbid autochtho- 
nous products of indigestion are attended by disorders of innerva- 
tion and nutrition, it is as yet impossible to say. The direct 
action of cold, an anaemic condition of the nerves, and reflex 
action from distant sources of irritation are among the other in- 
voked causes. Inflammation in the nervi nervorum is also invoked 
as a factor, but in this case the symptoms would not accord with 
the rule given above, since the nerve trunks would be very tender 
to touch or pressure, and the suffering would be unshifting and 
shown permanently in the one seat. 

Facial Neuralgia. I^afosse and Zundel describe as cases of 
this kind those in which periodically the horse's eyes are fixed 
and shining, the ears drawn back and depressed as in vice, the 
head at intervals bent on the neck, with plaintive neighing, rub- 
bing the head on the stall and pawing. Those cases of twitching 
of the head or rapid jerking of the ears in horses, when they 
have been driven for some distance, and which are relieved by 
wearing a close net over the nostril or by section of the trifacial 
nerve at the infra-orbital foramen, manifestly partake of this 
character. 

Cervico-Occipital Neuralgia. I^afosse speaks of this as 
often mistaken for torticolis, the head being turned to the af- 
fected side during the paroxysms. In man this is often a result 
of cold draughts on the back of the head, and associated with 
tender points on the course of the nerve, between the mastoid 
and the median line. 

Dorso-intercostal neuralgia causes pain in deep inspiration, 
and lumbo-abdominal neuralgia develops tenderness in the 
loins, in one testicle, or in one lip of the vulva according to 
Lafosse. Diagnosis between such cases and neuritis, spinal 
disease, and other obscure nervous affections must be very 
problematical. 

Sciatic Neuralgia. This is described by Zundel as causing 
jerking and lameness in the affected limb, sometimes aggravated 



Neuralgia. 189 

and sometimes improved by work and associated with muscular 
weakness or paresis. Sciatica in man is, however, rarely a 
simple neuralgia, but partakes rather of the nature of a neuritis, 
and there is no good reason for supposing that the disease of this 
nerve in the lower animals is other than an inflammatory 
condition. 

Ledainche after consideration of the testimony adduced, is of 
the opinion that we still lack absolute evidence of uncomplicated 
neuralgia in the domestic animals. 

Treatment, For toxic cases elimination of the poison is the 
first consideration. For lead carefully graduated doses of iodide 
of potassium to carry off the offending agent without increasing 
its poisonous action must be continued as long as the metal is 
passed by the urine. It may be followed by a course of strychnia, 
by electricity, massage and blisters. Gouty subjects may be 
treated with salicylate of soda, alkalies, or colchicum. The vic- 
tims of Bright* s disease must be treated for the kidney affection. 

Where there has been trouble of the digestive organs, in- 
testinal antiseptics (salol, sodium salicylate, bismuth-salicylate, 
beta napthol) and small doses of arsenious acid will sometimes 
benefit. 

In anaemic conditions a course of tonics (cod liver oil, iron, 
quinine, nux vomica) are indicated, and, to improve the local 
blood supply, nitro-glycerine. A rich stimulating ration, currying, 
an open air life, and sunshine (in summer a run at grass) are 
called for. 

In man with a suspicion of traumatic origin, W. H. Thomson 
strongly advocates a persevering use of the hot water douche to 
the parts first affected, the hypodermic use of morphia and 
atropia, and in case of local anaemia nitroglycerine every three 
hours. Where there is a suspicion of inflammation he success- 
fully employs absolute rest, with opium narcotism so as to abolish 
the pain, for twenty da>-s if necessary. Aconite, antipyrin, 
acetanilid, phenacetin. exaglin, and gelsemium have their 
advocates, and may benefit in individual cases. A course of 
arsenic is often successful, and phosphorous and ergot have each 
proved of value. 



ATROPHY OF NERVES. 

Prom arrest of fanction, from lesions, pressure, distal, bat at times central 
of lesion. Symptoms : Loss of function advancing to paralysis. Muscle 
atrophy. Prognosis : in absence of incurable cause, is hopeful. Union of 
divided ends, restoration of function. Treatment : time, ligature of divided 
ends. 

This is usually the result of arrest of function. It may be due 
to transverse section of the nerve, as in surgical neurectomy when 
the separated peripheral end of the nerve gradually wastes. It 
may come from contused wounds implicating the nerve and caus- 
ing destruction of its substance. It may be from tumors or other 
neoplasms pressing on the trunk of the nerve and preventing the 
passage of nerve currents. Or, inflammatory effusion may press 
on the nerve, as happens often to the crural in hsemoglobinuria. 
Or the pressure may come from enlarged mediastinal glands, or 
even from the distended posterior aorta under habitual violent 
exertion so as to permanently incapacitate and atrophy the left re- 
current laryngeal nerve as in chronic laryngeal paralysis (roaring) . 
Similar wasting occurs in other nerves under corresponding con- 
ditions. Atrophy may, however, extend centrally from the peri- 
pheral end of a nerve when it can no longer remain functionally 
active. We find an example of this in the atrophy of the optic 
nerve up to the commissure when the eyeball has been excised. 
A similar condition is often seen in horses in which the integrity 
of the eye has been completely destroyed in connection with re- 
curring ophthalmia. 

The symptoms attendant on atrophy of a nerve are those of im- 
paired function gradually advancing to complete paralysis of 
motion or sensation. In cases of a complete breach of continuity 
as in section or severe traumatism the entire loss of function 
necessarily precedes the atrophy. Again, when it comes from 
destructive changes in the coats and media of the eye, and of the 
ganglionic cells of the retina, the atrophy of the nerve trunk pro- 
ceeds simultaneously with the lesions of the organ of vision. 

The diagnosis will in many cases be easy as deduced from the 
traumatic or surgical lesion. In other cases it may be made with 
190 



Atrapy of Nerves. 191 

certainty from the complete muscular paralysis, wasting and 
degeneration of the muscles supplied by the nerve, and by the his- 
tory of the case (haemoglobinuria in atrophy of the triceps exten- 
sor cruris, roaring in atrophy of the laryngeal muscles and recur- 
rent nerve). In other cases, as in the eye, we have the atrophy 
of the eyeball, the distortion or complete paralysis of the iris, the 
opacity of the lens, or the exudation into the vitreous, choroid and 
retina when these can still be observed. 

Prognosis will depend on the cause. With a nerve severed with 
a knife or crushed in a part of its course and atrophied, without 
destructive changes in the organs in which it is distributed, repair 
is possible and to be expected in time. 

TWa/m^n/ is expectant, yet inflammation must be subdued, 
tumors removed, divided ends ligatured, etc. 



DISEASES OF THE URINARY ORGANS. 



Relative prevalence in man and animals. Causes of di£ference. Kidneys as 
eliminating organs for nitrogenous material, toxins, bacteria, mineral, veg- 
etable and animal poisons, diuretic drinking water, condition powders^ 
cantharides, urea, etc. Suppression of urine, precipitation of urine. Pil- 
tration through kidney. Secretion. Urinary solids. Nervous control of 
secretion. Excess. 



Diseases of the urinary organs are less prevalent in the lower 
animals than in man, owing largely no doubt to the greater sim- 
plicity of their habits of life and to the comparative shortness of 
the lives of those that are kept for meat producing. It is a mis- 
take, however, to suppose that they are so infrequent as would 
appear, since the absence of subjective symptoms in the animal 
allows a number of the milder forms of renal disease to be passed 
over without recognition. 

In man the excessive consumption of animal food, the lack of 
exercise, the abuse of alcohol, the prevalence of veneral diseases, 
conduce largely to renal troubles, while animals in general escspe. 
Yet animals suffer much more extensively than is generally sup- 
posed. The kidneys are, as in man, the eliminating organs for 
superfluous and waste nitrogenous matter, and in overfed animals 
may be overcharged with this work. They are the general 
emunctories for the soluble poisonous products of bacteria and 
plants, which may stimulate the urinary secretion, and from these 
irritation may result. It is through the kidneys that the bacteria 
themselves largely leave the animal body, and trouble is liable to 
come during their passage. Further, exposure to cold tends to in- 
crease the urinary secretion, over-stimulating the kidneys, and 
the same may come from diuretic drinking waters and condition 
powders, also from cantharides and other diuretic agents applied 
to the skin. Urea and many toxins are diuretic, hence the oc- 
currence of polyuria at and after the crisis of fevers. 
192 



Diseases of the Urinary Organs. 193 

On the other hand suppression of the urinary secretion 
may occur in connection with profuse perspirations in hot weather, 
with prolonged diarrhoea, or with privation of water, and in such 
cases the liquid becomes concentrated and irritating and there 
is a disposition to precipitate its solids under slight disturbing 
causes. As conducive to such precipitation may be named 
foreign solid bodies, bacterial ferments and probably the goitre 
poison since gravel and calculus are common in goitrous regions. 

There are two forms of elimination through the kidneys. 
I , filtration ; 2 , secretion . ^ 

1. Filtration is referred to the glomeruli, and is determined by 
the relative blood pressure. Increase of pressure causes increase 
of watery transudation. Digitalis increases heart action and 
arterial pressure, and accidentally urination. Excessive consump- 
tion of water and watery liquids increases intravascular ten- 
sion, and the amount of urine. 

2. Secretion is referred to the columnar epithelium of the 
convoluted tubes. It is by the elective aflSnity or selective 
power of this epithelium that the solids of the urine are ab- 
stracted from the blood and passed into the urine. Crystals of 
uric acid have been found in these cells and it is supposed 
that the abundance of water furnished by the glomeruli, irri- 
gating these convoluted tubes, dissolves and washes on the 
various solids and other products with which the epithelial cells 
are charged. The protoplasm of the cells becomes saturated 
with the urea, uric acid, hippuric acid coloring matter (indican, 
urochrome, etc.), and this is washed out, passing by exosmosis 
to the liquid of lesser density with which the tubes are filled. 

Nervous Control of Urinary Secretion. 

An electric current through the renal plexus of the sym- 
pathetic (vaso-motor) lessens, or suppresses urinary secretion 
(inhibition). 

Cutting the nerves of this plexus causes excessive vaso-di- 
lation, renal pulsations synchronous with heart beats and arterial 
pulse, and great increase of urine. A similar increase comes 
from the application of cold to the surface, from fatigue, from 
heat exhaustion, from irritation of the floor of the fourth ventricle 
13 



194 Veterinary Medicine, 

just in front of the origin of the vagus and from section of the 
splanchnic nerve. This last is, however, much less marked and 
more transient than from section of the renal nerve noted above ; 
the latter causing dilation of the renal vessels only, and increased 
pressure, whereas the former causes dilation of the abdominal 
organs generally, diverting the blood largely to other parts than the 
kidney and preventing the same increase of pressure in the vessels 
of the latter. For the same reason transverse section of the medulla 
oblongata, or of the spinal cord as far back as the seventh cervical 
vertebra, lessens or interrupts the urinary secretion, the pressure 
in the kidney being reduced by the diversion of much of the 
blood elsewhere. This influence of the nervous system on the 
urinary secretion seems to be mainly or entirely one of increase 
or decrease of blood pressure in the kidney. For this reason a 
weak heart tends to lessen urinary secretion. 

Excessive increase of urine is only important when con- 
tinuous and in the absence of visible cause, such as diuretics. 



PHYSICAL PROPERTIES OF THE URINE. 

Color, yellow, red, brown ; horse, ox, calf, sheep, goat, dog, cat, bird. 
In disease : pale yellow, with water in excess; deep yellow, red, brown with 
solids in excess, urobiline, biliverdin, hsemoglobin . Extraneous colors. 
Bilharzia. Translncency : Turbidity : horse, ruminants, carnivora, pig. In 
disease, horse, other animals. Consistency, viscous, stringy, tarry ; odor, 
horse, dog, cat, ammoniacal, foetid, drug odor. Specific gravity, estimate of 
solids ; reaction, acid, alkaline, neutral ; morbid chemical changes, sodium 
chloride, phosphate, alkaline, earthy, indican, urea, uric acid, hippuric acid, 
.phenol, creatinin, acetone, oxalic acid, allantoin, xanthin, hypoxanthin, 
cyanuric acid, lencin, albumen, glucose, bile salts and pigments, blood, 
hsemoglobin, epithelium, pus, casts 

Color. In estimating the color we must note the various 
shades of yellow, red and brown and compare these with the 
normal in different genera of animals, on different food and 
water, and in different conditions of health. Grades of color 
may be- stated as follows : 

Yellow : Pale, clear and deep yellows. 

Red : Reddish yellow, yellowish red, and red. 



Physic€U Properties of the Urine. 195 

Brovirn : Brownish red, reddish brown and brownish black. 

Color of Normal Urine. This varies with the species of 
animal, food, quantity of water drunk, and time of retention in 
the bladder. 

Horse : Urine is normally dear yellow, brownish yellow, or 
deep citron yellow, and the color is deepened by rich and abund- 
ant food (excess of solids) and by exposure to the air (changes 
in pigments). It may be sulphur white and sedimentary from 
precipitation of CaCO, when on green food. 

Ox, Calf, Sheep and Goat : Normal urine clear yellow to 
wine yellow. In the ox especially it is a pale straw tint, but 
varies to a deep brown on nitrogenous food (clover, peas, beans, 
cotton seed, lentils, pea or bean straw). Color may be due to 
indican and sometimes to indicanin or indigo blue, which ex- 
plains the blue urine sometimes described. 

Dog : Normal urine is yellow, straw-colored, aniline yellow, 
honey yellow, to brownish yellow in hot season or on dry nitro- 
genous food. Is always relatively deeper than in ruminants. 

Cat : Straw yellow to honey yellow, with variation as in the dog. 

Pig : Very pale yellow, more highly colored on dry feeding, 
nuts, peas, etc. 

Birds : ^\^ite or yellow, sedimentary. Mixed with faeces in 
cloaca. 

Color of Pathological Urine : Pale yellow with excessive 
secretion glycosuria, polyuria, cryptogamic polyuria, chronic in- 
terstitial nephritis, under diuretics, or after excessive drinking. 
The free secretion of a crisis in a fever is pale yellow. 

Deep yellow, deep red, deep brown color, indicates excess 
of urinary pigment (urobiline) and is deepened by nitric acid. 
This is seen in all hyperthermias with suppressed or diminished 
secretion, in privation of water, or food. This urine is acid even 
in herbivora. 

Yellow, saffron yellow, brownish yellow, greenish, olive, 
or brownish red indicate the presence of bile pig^ments (biliver- 
din, bilirubin) as in jatmdice or cholyuria. Bile salts should be 
tested for. A similar coloration may come from free consump- 
tion of carrots, or other yellow pigmentary matters. 

Red, brownish red, blood red, or deep brown color im- 
plies the presence of blood or blood coloring matter in the urine 



196 Veterinary Medicine, 

(hsematuria, haemoglobinuria). Exposed to the air this becomes 
brown or chocolate in ratio with the amount of blood or blood pig- 
ment present. Some such cases are complicated by blood clots. 

Color due to Foreign Constituents. 

Bronze or black color may come from injection of phenic 
acid. 

Deep green or olive green may come from tar, carbolic 
acid, salol, creosote, or derivatives of benzine taken in. 

Brownish green comes from thallin and reddens with iron 
chloride. 

Brown or blood red from rhubarb or senna. 

Purple red from santonin, if alkaline (if acid, is reddish 
yellow). 

Red from madder (it is alleged from indigo). 

Yellow from Carrots. 

Blue (indigo bine) may occur in urine of horse or ox when 
exposed to the air. 

Bluish green will come from feeding indigo. 

White or yellow color will result from the presence of pus. 

White chylous urine occurs with a haematozoon (Bilharzia 
Crassa) in the blood of cattle. 

Translucency . Urine may be passed clear and become turbid 
by standing. The presence of colloids hinders precipitation and 
prevents clearing. 

Horse : Urine is generally turbid, especially what has been 
long in the bladder, and that which is last passed. The turbidity 
is largely due to precipitation of calcium carbonate and bicar- 
bonate, and increases on green food, or if the liquid stands ex- 
posed to the air and is cooled. Not unfrequently the salts are 
thrown down as fine spherical granules, or there may be a white 
pultaceous mass. They are sometimes entangled in extremely 
mobile cylindroid masses coming from the uriniferous tubes during 
convalescence from fevers or during fasting. A fine pellicle on 
the surface is normal in horse's urine left in the air. 

Ox, sheep and goat : Urine is passed clear. May become 
turbid through the change of lime carbonate into bicarbonate in 
cattle but always more slowly than in the horse. 

Carnivora : Urine is passed clear but becomes turbid on decom- 
position, or if concentrated. With excess of fat in the food it 



Physical Properties of the Urine. 197 

• 

may become opaque from floating oil globules, apart from the 
classic chyluria. 

Pig : Fed on raw fresh vegetables the urine is clear, but if on 
cooked or dried Vegetables, and especially if nitrogenous, it may 
show opacity. 

Pathological : The horse's urine is limpid and acid in 
polyuria ; limpid and alkaline or neutral with modified phos- 
phates. It may be morbidly turbid from excess of lime phosphate 
or sulphate, urea or other add salts, exudates, leucocytes or pus. 
These usually indicate nephritis. Mucus and muco-purulent 
exudate suggest pyelitis or pelvic nephritis. Blood elements 
indicate nephritis, cystitis or urethritis. Debris of kidney tissue 
may indicate tuberculosis ; tumors, etc. 

Turbidity in other animals than solipeds is abnormal : examine 
the urine. 

Consistency of Urine. Morbid urine may be gluey, sizy, 
s)rrupy, mucous, oily. If a horse's urine is scanty a slight 
siziness may be normal and due to tenacious mucus from the 
pelvis of the kidney, and from the solution of mucin and epi- 
thelium in the alkahne fluid. Viscous, sizy, stringy, and 
tarry (pitchy) urine is found in pyelitis, pyelo-nephritis, or 
cystic catarrh, but not in polyuria owing to the presence of the 
solvent add. 

Odor of Urine. This is somewhat aromatic in horse and 
ox, disagreeable in the dog, and repulsively heavy in the 
cat. With polyuria the odor is less. If the urine has been re- 
tained and fermented it is ammoniacal, if there are ulcers or 
tumors it is foetid, in diabetes it smells of acetone, after 
taking turpentine it has a violet odor, and after phenic add, 
camphor, ether and other drugs it is variously modified. 

Specific Gravity of Urine in ratio to water 1000 : 



Horse, 


1020 to 1050 


(1040) 


Ox, 


1025 


1045 


(1030) 


Sheep; Goat, 


1015 


1065 


(1040) 


Dog, 


1020 


1060 


( 1040) 


Pig, 


1005 


1015 


(loio) 


Cat, 


1020 


* 1040 


(1030) 



In the horse the urine may be looi to loio in polyuria, in 
chronic interstitial nephritis, and in a crisis of fever attended by 



198 Veterinary Medicine. 

diuresis. It may be 1050 to 1060 in glycosuria. Undissolved 
solids that are merely suspended in the urine do not affect its 
density. 

A rough estimate of solids may be made by multiplying the 
last two figures of a specfic gravity expressed in four figures by 
2.33. The result approximates to the number of grammes of 
solids in 1000 cc. 

Chemical Reaction of Urine. The liquid is tested by litmus 
paper, red and blue, weakly impregnated. The normal reaction 
is determined by the food : the urine of carnivora and sucking 
herbivora is acid turning blue litmus red : the urine of vege- 
table feeders is alkaline turning reds blue. In the horse the 
alkalinity is mainly due to excess of lime bicarbonate, passing, 
with standing, into lime carbonate, the carbon dioxide being de- 
rived from organic acids (lactic, malic, citric, etc.), by oxidation. 
The hippurates are also alkaline in reaction. In dogs the acidity 
is due to lime and soda phosphates, sulphates, urates and oxalates. 

Pathologically we find the urine strongly alkaline from the 
evolution of ammonia from urea, in fermentations occurring with 
prolonged retention in the bladder or in cystitis. The urine 
is acid even in herbivora in all fevers in which appetite is lost or 
seriously impaired, and which the metabolism is excessive. 

Chemical Changes in the Urine in Disease. Sodium 
Chloride, is present in large amount in health (horse 25 to 35 
grammes, dog 0.25 to 5 grammes daily) is diminished in fever, 
anaemia, visceral and exudative inflammations. It is increased 
during the absorption of false membranes and exudates. It is 
thrown down by adding solution of nitrate of silver, the curdy 
white precipitate being insoluble in nitric acid. 

Phosphates of lime, soda, potash and, scantily, of mag- 
nesia are normally present (horse 0.08 to 0.60 gramme phos- 
phoric acid daily) and are present in excess in digestive disorders 
and in malnutrition of bones (rachitis, osteoporosis and rheuma- 
toid arthritis). The alkaline phosphates are very soluble and 
never precipitated. Earthy phosphates dissolve in acid urine, 
but are precipitated from alkaline. To a little of the urine add a 
few drops of acetic acid, followed by a few drops of uranium 
acetate. A yellow precipitate of uranium and ammonium double 
phosphate is thrown down. 



Physical Properties of the Urine, 199 

Indican (CgH^NSO^) is formed from indol which passes suc- 
cessively through the forms of indoxyle and indoxylid potassio- 
sulphate. This is normally present in the urine, the horse ex- 
creting I to 2 grammes daily, the dog o. 15 gramme. It is present 
in excess in intestinal indigestions, constituting indicanuria. It 
is tested by adding a drop of muriatic acid and one of a solution 
of chloride of lime to the urine, when it will show a blue ring, 
the depth of which indicates the relative amount. 

Urea (C O N,H^) the principal waste product of nitrogenous 
matter, is always present in considerable amount. The sound 
horse may eliminate 100 to 200 grammes daily, the dog 5 to 180 
grammes. It is present in excess in all fevers and inflammations 
unless urination is suspended or impaired, in cryptogamic diuresis, 
in mellituria, uraemia, nephritis'and cystitis. Test : The addition 
to a filtered solution of urine, freed from phosphates, of solution 
of acid nitrate of mercury, precipitates it as nitrate of urea. A 
simpler test is to add to a drop or two of urine on a glass slide a 
drop of nitric acid and heat gently. The nitrate of urea is pre- 
cipitated in the characteristic rhombic or hexagonal crystals as 
seen under the microscope. Heat urea crystals in a test tube : 
biuret is formed and ammonia escapes. Add a trace of a copper 
sulphate solution and a few drops of a 20 per cent, solution of 
caustic potash : a rose-red color is produced — the biuret reaction. 

Uric Acid (Cj H^ N^ O,). Traces only of this are found in the 
normal herbivorous urine, yet it is more abundant when on a full 
dry grain diet, on milk (suckling) or on animal food. The dog 
kept on animal food has a large amount. 

Pathologically it is produced in the dog and even in the 
horse in fever, overwork and starvation, the animal living on his 
own tissues. Interference with oxidation in the lungs seems to 
produce it as an arrest in the transformation of albuminoids to 
urea. The neutral urate of soda remains in solution : the acid 
urate of soda is precipitated. Test : To the urine add one-fourth 
its volume of muriatic acid and set aside for 24 hours in a cool 
place. On the bottom and sides of the glass and on the surface 
of the liquid will be found the yellowish red acicular crystals of 
uric acid. 

Hippuric Acid (C,H,NO,) is normally present in all urine, 
but is especially abundant in that of herbivora. The horse elim- 



200 Veterinary Medicine, 

inates 60 to 1 60 grammes daily. It has been found to be in- 
creased by feeding on dandelion, carrots, clover, asparagus, 
apples, plums, benzoic acid, oil of bitter almonds, toluol, cinna- 
mic or kinic acid. It is absent in sucking calves, and horses fed 
on grain devoid of husk. Pathologically it is increased in 
hyperthermia, icterus, some liver diseases and diseased kidneys. 
Test : Precipitate any albumen by nitric acid and boiling, then 
add hydrochloric acid which precipitates the hippuric acid in long 
needle-like crystals. Heated in a small glass tube it forms an oily 
liquid, and heated to redness gives off an odor of hydrocyanic 
acid (nitro-benzol) and carbon is left. This distinguishes alike 
from uric acid and benzoic. 

Phenol is produced by intestinal fermentation. The horse 
normally excretes about 3 grammes daily. Pathologically it ap- 
pears in excess in indigestions, abscesses, softened discharging 
tubercle, pyaemia, and septicaemia. Test : Dilute solutions of 
ferric salts give a blue coloration. 

Creatinin, a product of metabolism of albuminoids, is found 
especially in the urine of camivora and omnivora in health. It is 
pathologically increased when oxidation is interfered with, as in 
diseases of the lungs. Test : Add to the urine a very dilute 
solution of sodium nitro-prusside and then drop by drop, some 
solution of caustic soda, when a ruby red color is shown and dis- 
appears again on boiling. Acetic acid changes to blue. 

Acetone (C,H,0) is found in the urine of healthy omnivora 
and camivora and increased by excess of nitrogenous food. 
Pathologically it has been found in fevers with much blood 
change, in inanition, in cancer, in indigestions, and auto-intoxi- 
cations. Test : To several c c. of urine add a few drops of 
iodo-potassic iodide solution and caustic potash when iodoform 
will be abundantly precipitated with its characteristic color and 
odor. 

Oxalic Acid (CjHjO^) appears to be secreted in small 
amount by healthy kidneys and it may also come from the 
splitting up of uric acid after secretion. It is augmented by 
feeding agents rich in oxalic acid (beets, fresh beans, asparagus, 
tomatoes). Pathologically it abounds in certain indigestions, 
and is associated with lameness and emaciation. Test : Add 



Physical Properties of the Urine, 201 

lime water to the urine, and the white oxalate of lime is precipi- 
tated. 

AUantoin (C^ H^ N^ O,) is found in the urine of sucklings 
(calves) during the first few weeks of life, in pregnancy and 
when on a meat diet. It diminishes with the increase of vege- 
table food. 

Xanthin (CjH^N^O,) is found in urine as a result of imperfect 
oxidation of nitrogenous matters especially, which would other- 
wise pass into uric or hippuric acid. Its immediate antecedents 
in such transformation are guanin and hypoxanthin or sarkin. 
It is a rare constituent of urinary calculus. 

Hypoxanthin (C^H^N^O) is produced from fibrine in gastric 
and pancreatic digestion and in putrefaction, and is especially 
abundant in leucsemic subjects. 

Cy anuria Acid (C,jH„N,0.) occurs in dog's urine. 

Leucin (C. H„ N O,) and Tyrosin (C, H„ NO,) are products of 
pancreatic digestion of proteids, and the former occurs normally in 
the spleen, thymus, thyroid, liver, salivary glands, and urine. 
Both are present in large amount, in the urine, in acute atrophy 
of the liver. Test for leucin : Evaporate carefully to dryness 
with nitric add : the residue, if leucin, will be almost transparent 
and turn yellow or brown on the addition of caustic soda. If now 
heated with the soda it forms an oily drop. Test for tyrosin : 
treated with strong sulphuric acid, gently warmed and chloride 
of iron added, it gives a violet color. 

Albumen is an important morbid constituent of urine, which 
appears in a great variety of diseases (nephritis, pneumonia, 
epilepsy, anaemia, leucaemia, diabetes, haematuria, haemoglobi- 
nuria, hydraemia, infectious lung diseases, cardiac obstruction, 
venous stasis in the kidney, dermatitis, bums, lesions of the 
crura cerebri, floor of the fourth ventricle, spinal cord, or renal 
vaso motor nerves). It also occurs after violent exertion, in 
poisoning by strong acid, phosphorus, arsenic, lead, mercury, 
opium or alcohol, and when an excess of albumen is injected into 
the blood. All forms of albumen may enter the urine, but the 
most common are serum albumen, globulin of serum, propeptone 
and peptone. A simple test is to acidulate the urine with apetic 
acid and boil : if the precipitate does not dissolve on addition of 
nitric add, it is albumen. Sulphosalicylic add added to the urine 
will cause a predpitate in urine containing only ^^rhrir ^^ albumen. 



202 Veterinary Medicine. 

Glucose (CgH„Og) is often normally present for a short 
period in small amount after a full meal of farinaceous material. 
It is permanently present in excess in glycosuria, which may re- 
sult, among other conditions, from diseased liver, punctured 
medulla, suppression of milk secretion on weaning the calf, oil 
of turpentine, nitrobenzole, nitrotoluol or amyle nitrite. Test : 
Add yeast to the urine and keep at 15° to 20° C. when if glucose 
is present, it becomes cloudy and gives off carbon dioxide, or add 
a little caustic potash solution, and a few drops of cupric sulphate 
solution until it is blue : then heat and a red precipitate of cupre- 
ous oxide is thrown down. The amount gives the ratio of glu- 
cose. Uric acid, hypoxanthin or mucus causes brown precipitate 
in the absence of glucose : peptone, creatin, creatinine, pepsin 
and urinary pigment prevent its formation though glucose be 
present. 

Bile Salts and Pigments are present in excess in cases of 
icterus, where these characters may be studied. See Icterus. 

Blood and Hsemoglobin in Urine. In a variety of diseases 
(anthrax, haematuria, nephritis, Texas fever, haemoglobinuria, 
etc.; blood or blood coloring matter escapes in the urine. When 
blood escapes one finds the reddish color, and under the micros- 
cope red globules, normal or crenated (especially in alkaline 
urine), free, aggregated in masses, in small clots, or embedded in 
casts of the uriniferous tubes. Under the spectroscope the spec- 
trum shows two dark absorption bands, one in the yellow and one 
in the green. When the color is due to haemoglobin the urine 
shows under the microscope numerous masses of amorphous 
brown pigment, and the spectrum shows one dark line in the yel- 
low, and three others less deep, (but one of them very broad) on 
the limit of the green and blue. Urine which contains the ele- 
ments of blood is usually turbid and thick or glairy, by reason of 
the presence of salts, albumen and fibrine. There may also be 
crystals of urinary salts (calculi), fragments of broken down 
tissue (tumors) or the ova of worms. 

Epithelium in Urine. The slight cloud seen in healthy 
urin^ contains epithelial cells. The source of these may be often 
determined under the microscope. The bladder epithelium are 
the most numerous, the largest, and are squamous. Those from 
the ureters and renad pelvis are also squamous, but neither so 
large nor so numerous. The epithelium from the uriniferous 



Physical Properties of the Urine. 203 

tubules are polyhedral with large nucleus, or columnar. The cells 
from the male urethra are also largely columnar. In cases, how- 
ever, in which these cells are passed in large amount because of 
catarrh of the mucosa all alike tend to assume the globular form 
with large nucleus so that their true source cannot be certainly 
stated. It is only from such cells as have become detached with- 
out change of form that the seat of desquamation can be deter- 
mined. If an excess of cells approximating to the kidney type 
are associated with albuminuria and cylindroid casts they become 
diagnostically significant. Polygonal cells darkly granular with 
large oval nucleus and nucleolus suggest kidney inflammation. 
If the granules are freely soluble in ether there is probably fatty 
degeneration. If hard, tough and glossy they suggest (but 
don't prove) amyloid degeneration. 

Pus Cells in Urine. Pus cells, with multiple nuclei revealed 
by adding dilute acetic acid, may be found in small numbers in 
apparently healthy urine. When present in large numbers, they 
usually indicate a catarrhal affection of the mucosa, and especially 
pyelitis, cystitis, or urethritis. There is always cloudiness, excess 
of mucin, and in the alkaline herbivorous urine, the liquid may 
be glairy or stringy. 

Casts of the Uriniferous Tubes. These usually indicate 
the existence of nephritis, yet they may be present in small num- 
bers in the urine of healthy individuals under a slight toxic 
action such as alcohol. 

Unorfranized casts of urinary salts or haematoidin found in 
sucklings appear to have no pathological significance. Organized 
casts, on the other hand, usually imply renal troubles, and 
especially inflammation. As these will be fully described under 
Bright' s disease, it need only be noted here that they may be 
composed in great part of red globules, leucocytes, epithelium, bac- 
teria, granules, a homogeneous wax-like matter, fat globules, hya- 
line matter, or urinary salts. The predominance of one or other 
of these determines the nature of the cast. 

The observations of Mayer, Knoll, Bovida, Von Jaksch and 
others seem to show that the basis substance of urinary casts 
differs from all our familiar proteids and must be considered as a 
distinct nitrogenous compound, a derivative of one of the com- 
mon proteids. 



GENERAL SYMPTOMS OF URINARY DISEASE. 

External symptoms, arched back, stiff gait, straining, tender loins, back- 
ing, turning, dropping under weight, urine checked, dribbled ; in dogs and 
cats, palpation of kidney ; bladder, urethra, pains in different animals. In- 
ternal symptoms, rectal exploration, vaginal, urethral, straining, ureters, 
bladder, calculi, neoplasms, prostate, urethritis. 

External Symptoms. With inflammatory or painful affec- 
tions of the urinary organs the animal tends to roach the back 
or loins, tuck up the abdomen, move the hind limbs stiffly and 
with a straddling gait, protract and withdraw the penis which 
may be semi-erect, retract and drop the testicles alternately, 
and stretch himself and strain to pass urine without success. 
Lying down and rising may be accomplished with marked 
effort and groaning. The loins along the spines or beneath the 
outer ends of the transverse processes may prpve tender to tapping 
or pinching, the animal drooping to excess. Backing or turning 
in a narrow circle may be accomplished awkwardly and stiffly 
though usually more easily than with lumbar sprain. The 
animal drops when mounted but less than with sprained back. 
Urine may be passed in excess or in diminished amount, or it may 
be entirely suppressed. It may be abruptly interrupted when in 
full stream, suggesting calculus or polypus, or it may be passed 
often in mere driblets, or finally it may ooze away constantly 
partly lodging in the sheath and partly trickling down the thighs. 

In dogs or cats with flaccid walls of the abdomen external 
manipulation may detect in the kidneys, differences in size, posi- 
tion, and tenderness as well as the presence of tumors. The dis- 
tended bladder also may be distinctly felt, and the pyriform area of 
flatness on percussion will serve to map out its size and outline. 

In the horse the urethra is superficial and easily traced over 
the ischiatic arch and for some distance downward, when it be- 
comes deeper and is less easily felt. In the bull the urethra is 
deep over the ischiatic arch but becomes more superficial lower 
down and can be easily felt at the sigmoid flexure and below. In 
sheep and dog it is easily followed from the ischium to the end of 
the penis. 

As a rule the penis is easily drawn from its sheath in the horse 
204 



General Symptoms of Urinary Disease,, 205 

and dog ; this is more difficult in the sheep and goat and still 
more so in the bull and boar. In the small animal protrusion is 
favored by setting him on his rump, with his back between the 
operator's legs, and pelvis doubled forward toward the 
sternum. The penis of the bull may be extended in presence of 
a cow in heat, and promptly seized, or it may be seized through 
the sheath back of its first bulging part and skillfully worked out. 
In the ruminant, calculi may be felt at the sigmoid curve, and in 
the ram, in the vermiform appendix at the free end of the penis. 

Internal Exploration. This is accomplished in the larger 
animals with the oiled hand in the rectum, the nails having been 
pared short and even to avoid injury to the mucosa. In ponies 
and yearlings the kidney may be felt, and this may be true also 
of mature animals of larger species in cases of hypertrophy or 
floating kidney. The ureters, bladder and intrapelvic urethra 
are easily felt in the male. The empty bladder lies on the an- 
terior border of the pelvis ; when full, it projects forward into the 
abdomen but retains its pyriform or, in the very young animal, 
its fusiform shape. In the female the sensation is somewhat 
modified by the presence on its upper surface of the uterus divid- 
ing into its two horns anteriorly. The single enlarged horn of 
pregnancy is especially misleading. 

The female urethra, cervix and bladder may be explored 
through the vagina. To explore the cervix vesicae and urethra 
the fingers are slowly drawn back from the bladder along the 
median line of the floor of the vagina. In the mare the cervix 
and adjacent portion of the bladder can b^ further explored-' with 
the index finger introduced through the opening of the urethra 
in the floor of the pelvis and at the junction of the vagina and 
vulva. In the cow the urethra is too small to be readily explored 
from within, and the orifice is still further guarded by the two 
lateral blind canals of Gaertner, into which the unskilled fingers 
more readily pass. Success only attends the careful search for 
the small central lower orifice. In the smaller animals the finger 
only can be introduced into vagina or rectum and the urethra, 
cervix and bladder only can be felt. The result of such explora- 
tion is straining even in healthy conditions but which becomes 
excessive in nephritis, pyelitis, renal, uretral, vesical or urethral 
calculus, cystitis, rectitis or enteritis. 



2o6 Veterinary Medicine, 

The ureters are tender when inflamed, and they are swollen in 
calculous obstruction with an elastic feeling in front of the stone. 

The bladder is very sensitive when overdistended, inflamed or 
pendent on the abdominal floor, or when the seat of calculus. 
In the absence of any liquid contents a calculus is felt as a hard 
solid mass firmly clasped by the contracted vesical walls. If 
liquid is present the solid hard calculus is felt movable in the 
fluid. An empty contracted bladder is firm and p5aiform. 
An empty flaccid bladder, resulting from rupture or exhaustion, 
is flabby, with indefinite form and, if the seat of a lesion, tender. 
It varies in consistency with neoplasms (papilloma, sarcoma, car- 
cinoma, or epithelioma). These have not the free mobility of 
the calculus floating in urine, and their point of connection with 
the wall may often be made out. When a solid body is felt, or 
suspected to be in the contracted bladder, an injection of sterilized 
water will usually facilitate diagnosis, and a differentiation of 
calculus and neoplasm. 

Hypertrophy of the prostate is felt as a swelling of uneven 
outline over the cervix vesicae. It is to be looked for especially 
in old dogs. 

Urethritis is indicated by swelling and tenderness along the 
median line of the pelvic floor, back of the cervix. With a cal- 
culus in the urethra the swelling is more strictly localized and the 
canal in front of it may be full and elastic. 



HiEMATURIA. 



Symptoms of different lesions of kidneys and constitutional states, of 
poisoning by irritant plants, common on moors and in woods. In puerperal 
cow fed on turnips raised on mucky, unreclaimed, sour lands. Bacteria. 
Toxins. Ansemia. Poor wintering. Limed new soils. Symptoms : in plethoric, 
congested mucosae, vascular tension, hurried breathing, colics, straining, 
red urine ; in vegetable irritants, depression, weakness, coldness, trembling, 
stiffness behind,scanty red or black urine, diarrhoea, constipation ; in ansemia, 
poverty, debility, red urine, pink tinge in milk, emaciation, hide-bound, 
anorexia, colics. Chronic or intermittent. Lesions : in plethoric, congested 
enlarged kidney, without softening ; in irritant poisons, congestion also of 
throat, stomachji, intestines, liver with hsemorrhagic extravasations ; in 
ansemia, kidneys pale, flaccid, hydroaeniia, liver enlarged, softened, reddish 



Hematuria. '207 

liquids in serous cavities. Treatment : avoid the injurious soils, drain, cul* 
tivate, feed products of such soils with other food, oleaginous or saline laxa- 
tives, antiferments, tonics, astringents, flax seed, farinas. 

The passage of blood or blood elements in the urine. 

Causes, A symptom of a variety of diseases, producing lesions 
of the secreting structures of the kidneys ; acute congestion, 
tumors, calculi, parasitism. Also as a manifestation of diseases 
of distant organs — ^haemoglobinuria, southern cattle fever, an- 
thrax, poisoning by irritant diuretics, wounds of the bladder, 
pelvic fracture with injury to bladder or urethra, cystitis with 
varicose cystic veins, etc. 

Among the irritant plants charged with producing the affection 
are the young shoots of oak, ash, privet, hornbean, alder, hazel, 
dogberry, pine, fir, and coniferae, generally. Also ranunculus, 
hellebore, colchicum, mercuriales annua, asclepias vincetoxi- 
cum, broom, etc. The disease is common in spring in cattle 
turned out too early to get good pasturage and which, it is 
alleged, take to eating the swelling buds and young shoots of 
irritant plants. 

The disease has occurred mostly in woods and wild lands and 
has accordingly been vulgarly named the wood evil, (maladie de 
bois, holzkrankheit), and moor ill. 

In England, as occurring in the puerperal cow, Cuming, of 
Ellon, attributes it to a too exclusive diet of turnips. His analy- 
sis showed that turnips contained 10% sugar and i to i^% 
vegetable albumen. The sugar is held to stimulate unduly the 
milk secretion, but fails to supply the nitrogenous materials need- 
ful to form it and the cow is speedily rendered anaemic, with 
solution of the blood globules or of the haematin and its excre- 
tion by the urine. No attempt was made to produce haematuria 
by an exclusive or excessive diet of sugar, and cows fed on 
turnips grown on well drained lands never suffered from the 
disease. 

Williams says that urine in such cases had a strong odor of 
rotten turnips. This argues not an anaemia determined by sugar, 
but rather an intestinal fermentation, perhaps superinduced by 
ferments introduced along with the turnips. Add to this the 
notorious fact that the offending turnips are usually such as are 
grown on wild, damp, undrained, swampy, or mucky lands, and 



2o8 Veterinary Medicine, 

we have the suggestion of a bacteridian poison, or a toxic product 
of bacteria. Williams and Reynal practically agree on the point 
that the common haematuria is the result of anaemia. It has long 
been noticed that the herds which suffer from the affection are 
those which have come out of the winter in low condition, the 
victim is the poor man's cow, and the symptoms are most likely 
to appear when turned into the fields in spring before the pastures 
have come up. The anaemic condition of the carcasses is quoted 
in support of this view, but perhaps without making sufficient 
account of the extraordinary destruction of blood globules during 
the progress of the malady. 

Pichon and Sinoir see in the liming of soils and the production 
of larger crops, a cause of anaemia in the rank and aqueous 
growth of the meadows, and their overstocking in order to eat 
them down, or to consume their products. They found that an 
abundant artificial feeding was the most efficacious mode of 
treatment. 

Reynal, who endorses this view, tells us that in the anaemic 
and liquid blood the globules become smaller and can pass more 
readily through the walls of the vessels. But this is exactly the 
opposite effect from what we see when the blood is diluted with 
water. The globules in such a case are distended and enlarged, 
and may finally have their protoplasm and haematin dissolved 
and diffused through the liquid. If the blood globules are 
shrunken, then we must look for a cause very different from 
anaemia. 

Reynal further assures us that plethora is a common cause of 
haematuria in cattle. *' Under the prolonged influence of a very 
assimilable diet, the blood becomes more plastic, circulates with 
difficulty in the capillaries, and may even rupture them, with a 
resulting capillary renal haemorrhage, and bloody urine.'* He 
further intimates that this occurs especially in spring after the 
animals have been turned out on very rich pastures, and that in 
Normandy certain pastures of unusual richness are notorious for 
producing haematuria. 

Apart from the fact that the rich grasses of spring produce at 
first intestinal congestion, and diarrhoea, with consequent disorder 
of the liver and kidneys, this spring affection on particular pas- 
tures suggests some special poison in the pasture as the unknown, 
cause of the disease. 



Hematuria, 209 

In all forms alike of this affection the nature of the soil ap- 
pears to have a preponderating influence. It is the disease of 
the woods, and waste lands, of damp and tmdrained lands, of 
dense clays, of lands underlaid by clay or hard pan, of lands rich 
in vegetable humus, or vegetable moulds the decomposition of 
which has been hastened by the application of quicklime. 

Pottier, Salom6, Wiener and Reynal especially testify to the 
prevalence of haematuria on soils that. are either dense and im- 
permeable, or that have a subsoil of clay or hardpan. 

The disease has not been traced to any definite microbe nor 
toxin, but there is much to suggest the necessity for inquirj*^ in 
that line. The special susceptibility of animals that may be 
plethoric on the one hand, or in low condition on the other, would 
be entirely in keeping with such a view, as the debility or de- 
rangement of health would lay the system open to attack. 

Symptoms, In the plethoric animal there are congested mu- 
cosae, full, strong pulse, forcible heartbeats, full veins, accelerated 
breathing, colicy pains, dullness, straining frequently and the dis- 
charge of thick, red or bloody urine. 

If from irritant buds and shoots, or plants, there is more de- 
pression, weakness, fever, dry skin, staring coat, coldness of the 
surface, tremblings, stiffness or weakness of the hind limbs, 
diarrhoea, followed by constipation, frequent straining and the 
passage of colored urine with pain. In violent cases the expul- 
sion of bloody urine may be excessive, and the cow may die in 24 
hours. From irritant plants however the quantity of urine is 
liable to be small, but frequently passed. 

As occurring irrespective of plethora or irritants there may be 
at first only poor condition and debility with the passage of blood. 
A pink tinge may show on the froth in the milk pail, and a red 
precipitate on its bottom. If not anaemic at the outset they soon 
become so, and the pulse which was at first bounding becomes 
small and weak, the heart palpitates, the red mucosae become 
pale. The subjects become tucked up, emaciated, weak, rough 
coated, the skin adherent to the bones, and the appetite and 
rumination impaired or lost. Sometimes colics are present. 

In the milder anaemic forms it may continue for months before 
it causes death. In such cases it may prove intermittent. 

Morbid Anatomy, In the haematuria of plethora the kidneys 
r4 



2IO Veterinary Medicine, 

are large, congested and of a dark red, but preserve their normal 
consistency and texture. 

In the form associated with ingestion of irritant plants, there is 
congestion of the pharynx, stomachs, and intestines with 
haemorrhage c spots, congestion of the liver, violent congestion of 
the kidneys which are of a blackish red color, and enlarged to 
perhaps twice the normal size, with haemorrhagic exudations, the 
convoluted tubes filled with fibrinous exudate and blood globules, 
the pelvis red and like the bladder containing some reddish urine. 
The vesical mucosa may be black. 

In anaemic cases the kidneys are pale, flaccid and colorless, with 
a reddish liquid in the pelvis and bladder. The vascular system 
is comparatively empty, and the blood, thin and watery, and often 
coagulates loosely or not at all. As noted by Herland globules 
are greatly reduced in numbers and size, and often crenated or 
partially broken down. Slight serous effusions in the serous 
membranes are common. The liver is softened and enlarged, the 
lacteals have reddish contents, and the ingesta are dark colored. 

Treatment, Preventive, Avoid haematuria pastures and the 
fodder grown on such lands. Drain and cultivate such soils. 
When animals must feed on the products of such soils supplement 
the food by grain, oil cake, cotton seed meal, etc. Avoid stag- 
nant waters draining from such soils. 

Therapeutic Treatment, Give oleaginous or saline laxative to 
clear out poisons and ferments from the bowels and add if 
necessary an antiferment (salol, salicylic acid, carbolic acid, tur- 
pentine oil, chlorate of potash, sulphites or hyposulphites), even 
if diarrhoea is present. Follow with tonics (copperas, chloride 
of iron) and stimulant antiseptics (ol. terebinth, potas. chlorate) 
and sound food. Flax seed, linseed meal, farinas. Bitters may be 
added (gentiAn^ quinine, quassia). As a calmative, camphor (2 
to 4 drs. ) 2 or 3 times a day has proved useful. 

In case of nephritis treat as for that affection. 

Weiner lauds empyreumatic oil and oil of turpentine with cam- 
phor. 

In chronic cases, nourishing food with change of locality and 
water are very important. 

A course of iron tonics should wind up the treatment. 



ACUTE CONGESTION OF THE KIDNEYS IN SOLIPEDS. 

Definition. Causes : bacteria, toxins, irritant diuretics, musty oats or 
fodder, foul water, cantharides, turpentine, aqueous grasses, onions, moult- 
ing, cold, chills, injuries to loins, over driving. Lesions : kidney enlarged, 
red, black, softened, capsule loose, cut surface drops blood, brown, sqftened 
necrosed areas, gorged capillaries of glomeruli and convoluted tubes, 
granular or fatty changes in epithelium, may be ruptures. Symptoms: 
sudden ; weak tender loins, slow dragging straddling gait, accelerated pulse 
and breathing, anxious countenance, colics, sweating, urine from limpid to 
black, with red globules, and casts. Prompt recovery or nephritis. Diag- 
nosis : from nephritis, hsemoglobinuria, laminitis, indigestion. Prevention : 
Treatment : bleeding, laxatives, diffusible stimulant diuretics, bromides, 
diluents, mucilaginous agents, fomentations, sinapisms, rectal injections, 
clothing, friction to the skin, restricted laxative diet. 

Definition . Active congestion of the renal capillaries, especially 
of those of the glomeruli and convoluted tubes, with colicy pains, 
and free discharge of urine, in some cases bloodstained. 

Causes, It may be determined by local irritation caused by the 
passage of the bacteria and toxins of infectious diseases such as 
influenza or contagious pneumonia. In the same way irritant 
diuretics, medicinal, alimentary and toxic, operate. Diuretic 
balls and condition powders given recklessly by stablemen and 
grooms, saltpeter, resin, oleo resins, turpentine, rue, savin, col- 
chicum, squill, anemone nemorosa, adonis, cynanchum vincetox- 
icum and other species of ascelepias, hellebore, mercurialis annua 
and bryony are examples. The young shoots of the coniferous 
plants, fir, balsam fir, pine, white and yellow, and hemlock, 
are at times injurious. 

In the same way, damp moldy oats or fodder produce renal 
congestion and excessive polyuria, also corrupt, stagnant water 
and that of marshes which often contains complex toxic products 
of fermentation. Water of ponds in which cantharides or potato 
beetles have been drowned, is dangerous. The cantharides, eu- 
phorbium, or oil of turpentine applied too extensively to the skin 
as a counterirritant, is another factor. 

Even the rich aqueous grasses of spring succeeding to the dry 
winter diet, stimulate the kidneys, determining an active conges- 
tion with polyuria and in bad cases haematuria. In many such 

211 



212 Veterinary Medicine, 

cases there are superadded the acrid diuretic plants already re- 
ferred to. In Denmark where onions are g^own on a large scale, 
the tops fed to Unimals have produced* renal congestion. ^ 

There appears to be an extra susceptibility in spring when the 
winter coat is being shed, and at this time especially, but also in- 
dependently of this and at other seasons, exposure to cold and the 
occurrence of chills tend to induce an attack. Exposure to cold 
storms of rain or sleet when perspiring or fatigued, standing tied 
out of doors in zero weather without a blanket, wading or swim- 
ming deep rivers in cold weather and while fatigued, standing 
wet and unblanketed in a cold stable when returned from work, 
exposure to draughts between open windows or doors, the con-' 
tinuous falling of cold rain from a leaking roof on the loins, the 
cold of a damp stable newly finished in brick or stone, the cold 
and damp of an undrained floor in a wet retentive soil, all have 
a tendency to drive the blood from the surface, to increase the 
tension of the blood in the heart and internal organs, to stimulate 
the kidneys to extraordinary secretory activity, and at the same 
time to temporarily debilitate the whole system and lessen the 
power of resistance and recuperation. The factor is especially 
potent when it involves the nervous interdependent sympathy 
between the chilled loins or abdomen and the kidneys. Sprains and 
other injuries of the loins have long been charged with producing 
renal congestion and inflammation, and even Trasbot, who doubts 
the reality of this, acknowledges that the already diseased kidneys 
are seriously injured in this way. Cadeac and Schmid record 
cases of actual rupture of the horses* kidney from violent move- 
ment, and other cases of congestion and bloody urine have been 
traced to kicks on the loins, falls, sprains and the carrying of un- 
duly heavy loads. The overexertion which produces albumin- 
uria, casts and sanguineous transfusion in athletes has a similar 
effect on the overdriven race horse, trotter or draught horse. 

Lesions. The congested kidney is enlarged, sometimes to two 
or three times its natural size, softened, and red, especially in 
the cortical portion which may be so dark as to appear cyanotic. 
* The capsule is also the seat of ramified redness, and is very 
loosely adherent to the cortex. Beneath it may be considerable 
yellowish exudate especially abundant in the vicinity of the 
hilus. On section the cut surface is very bloody, the cortex 



Acute Congestion of the Kidneys in Soiifieds. 213 

literally dropping blood, though brownish spots may appear at 
intervals representing areas of necrosis, which under pressure 
break down into a pulpy debris. Microscopically the glomeruli 
appear hsemorrhagic, the capillary vessels being gorged to ex* 
cess, while blood globules and even minute blood clots are found 
in the intervascular spaces. The epithelium covering the glom- 
eruli and lining the convoluted tubes show granular or fatty 
changes, and granular matter is found outside the vessels. 

The congestion is less in the medullary portion and even in 
the convoluted tubes and the tubes of Henle, though these may 
be the seat both of hyperaemia and exudation. 

In case of very violent congestion, extensive sanguineous ex- 
travasation may occur, leading even to rupture of the capsule 
and the escape of blood into the perirenal adipose tissue or into 
the abominal cavity. Cases of this kind in the soliped are re- 
corded by Caroni, Cadeac, Moussu, Kitt, Zundel, MoUereau and 
Porcher. Averons describes in the Revue Veterinaire (1897) a 
case in which both kidneys were surrounded by an immense 
black clot, and weighed no less than 36 lbs, Leblanc records a 
similar case affecting the one kidney. The mass measured about 
10 inches by 8. 

Symptoms, These are liable to appear suddenly, often while 
the patient is at work, and are manifested by weakness in the 
loins, slow gait or sudden stopping, the hind limbs are held in 
abduction, and advanced with apparent stiflFness and pain. There 
is much excitement and anxiety, the face is pinched and strained, 
the respiration accelerated, the pulse hard, tense and rapid, and 
the eyes or nose may be turned toward the flank or loins. There 
may be colicy pains, with uneasy movements of the tail and hind 
limbs, pawing, and even lying down and rolling. The visible 
mucosae are strongly injected and in bad cases the skin may be 
drenched with sweat. There is at first little or no hyperthermia. 

At first there may be no micturition but in an hour or more, 
urine may be discharged in excess, sometimes as much as 25 quarts, 
and of a low specific gravity (looi to 1005). If there has been 
no blood extravasation it is usually clear and limpid but with ex- 
travasation it may be of all shades of pink or red to black. In 
the latter case the suffering is liable to be acute (Cadeac), and 
contrary to the condition in haemoglobinuria, the urine contains 



214 Veterinary Medicine. 

blood globules and even tubular coagula representing the 
uriniferous tubes and entangling the blood cells. This is com- 
plicated by albuminuria. 

Course, Duration, The congestion is short lived. It speedily 
undergoes resolution with the passage of normal, clear urine, and 
the recovery of appetite and spirit, or it becames rapidly aggra- 
vated, with continuous suffering and colic, complete loss of appe- 
tite, dullness, constant decubitus, weakness, debility, small or 
imperceptible pulse, palpitations, darker color and perhaps com- 
plete suppression of urine, and stupor or other nervous disorder. 
Death may occur on the fourth to the sixth day. It may be 
delayed by a partial recovery followed by a relapse. 

Diagnosis. Acute renal congestion is distinguished from 
nephritis by the suddenness of the onset, the absence of fever 
and the comparative absence of tenderness of the loins, and of 
tubular casts. 

From hamoglolnnasfnia it is distinguished by the absence of the 
conditions under which that affection appears: — the previous 
heavy work and full rich feeding, the day or more of complete 
rest on full ration, and the sudden exercise following. The hind 
parts in haemoglobinaemia are benumbed, paretic, or paralytic 
and not unfrequently rigid and swollen, and the brownish or 
reddish urine contains haemoglobin in amorphous particles, and 
not red blood globules and sanguineous tubular casts as in renal 
congestion. 

From laminitis it is distinguished by the absence of high fever, 
by the absence of the advance of the fore feet resting on the 
heels, of the heat and tenderness of the feet, by the ability to 
bear the lifting of one fore foot, or the tap of a hammer on the 
toe, by the lack of improvement after the first few steps as is 
seen in laminitis, and by the absence of the strong pulsations 
in the digital arteries. 

From indigestion it is distinguished by the absence of the his- 
tory which leads up to that condition, of abdominal tympany, of 
rumbling, of impaction and of frequent attempts to defecate, and 
by the presence of the stiffness, straddling, and the blood globules 
and albumen in the urine of low density. 

Prevention, This must be sought by the avoidance of all the 
factors of causation : — ^autointoxication in contagious diseases. 



Acute Conj^estion of the Kidneys in Solipeds. 215 

excessive renal irritation from the injudicious use of diuretics, or 
the accidental ingestion of irritant or acrid diuretic plants or 
waters, or musty fodders, or the sudden change to the succulent, 
watery, first vegetation of spring, or of exposure to cold, wet, or 
damp, in all their forms, or of direct injury to the back or loins 
by blows, shocks, or violent exertions. 

Treatment, Trasbot and Cadeac strongly recommend vene- 
section, and at the very outset in specially acute cases the sud- 
den lessening of the arterial and capillary tension, by this potent 
means, may furnish the opportunity for the capillaries of the 
glomeruli and tubes to regain their normal tone, and thus contri- 
bute to a speedy abortion of the affection. If resorted to at all it 
should be made in a full stream from the jugular, so as to secure 
the fullest and most prompt result with the least possible effusion 
of blood. 

Much, however, must depend on the attendant conditions. In 
toxin poisoning following on an infectious fever, the already 
existing debility will sufficiently forbid a resort to the lancet, and 
we must seek elimination by the bowels, the skin or even the kid- 
neys. Antiseptics, too, are in order if there appears any ground 
for suspicion of the action of infecting agents. Some cases will 
recover promptly under diffusible, stimulant diuretics such as 
spirits of nitrous ether, which by stimulating the circulation in 
other organs and especially the skin, appears to relieve the kidney 
and solicit normal secretion. But most veterinarians dread the 
stimulus and irritation and prefer small doses of refrigerant diure- 
tics : bicarbonate of soda 4 drs. , saltpeter 2 drs. or the tartrates, 
citrates or acetates of the alkaline bases. In case of irritation by 
acrid diuretics, but especially by cantharides, camphor 2 drs., has 
been found to be particularly soothing, and next to this, bromide 
of camphor or bromide of potassium i to 2 drs. may be resorted 
to. Zundel prescribes acidulated camphorated drinks. The free 
use of mucilaginous drinks, such as boiled flax seed ; and the 
persistent application of fomentations or wet compresses to the 
loins are of equal value in soothing irritation. Sinapisms may 
advantageously follow the local emollients. 

Laxatives act with less promptitude than diuretics, but on the 
whole constitute a safer treatment ; since they secure elimination 
and derivation without risk of irritation to the kidneys. The 



2i6 Veterinary Medicine. 

oils : castor i to 2 pints, linseed 2 pints, or olive 2 pints, are 
especially to be recommended in this respect, but T Homme advises 
manna, and calomel may also be used as a substitute. Injections 
of warm water are valuable in unloading the rectum and colon, 
soothing the kidneys and soliciting peristalsis. 

A restricted amylaceous diet is essential, and a warm stall or 
abundant clothing. Grooming or active rubbing of the skin 
tends to active derivation and often materially relieves. The case 
should nol be abandoned until a day or two after the urine has re- 
turned to the normal, and for some time special care should be 
taken of the diet, stabling and work. 



ACUTE CONGESTION OF THE KIDNEYS IN CATTLE. 

Caaaes : infection, toxins, etc., irritant diuretics, chilU, moulting, swill. 
Lesions : cortical kidney congestion, red to black, softening, friability ; 
urine limpid to red, with blood globules, albumen, and crystals. Symptoms : 
chill, tender loins, colic, straining, recovery in four days. Diagnosis : from 
haenioglobinuria, C3Stitis, calculus. Prevention : diet, etc. Treatment: 
laxatives, flax seed, wet compresses, bromides, camphor, disinfectants, 
bitters. 

Causes. In cattle this malady is largely traceable to the same 
causes as in the horse, and is very often but a complication of 
some other affection. The renal congestion of infectious diseases 
is seen in the advanced stages of lung plague, in anthrax, in 
malignant catarrh, in haemoglobinaemia, and implies an ac- 
cumulation of irritant toxins in the system. The abuse of 
diuretics, the ingestion of acrid diuretic plants, including 
the early shoots of the coniferae, the introduction through 
any channel of cantharides or potato beetles, the drinking of 
stagnant water charged with deleterious fermentation pro- 
ducts, the consumption of musty or spoiled fodder, and the sud- 
den change to the succulent grasses of spring, operate as in the 
horse. So it is with cutaneous chills, cold stone floors, cold wet 
storms, draughts and dropping from a leaky roof. The shed- 
ding of the coat in spring is an undoubted predisposing cause. 

Cattle in the swill stables of breweries and distilleries are the 
subjects of a constant renal congestion and polyuria, which, 
however, does not prevent rapid fattening. This diet, how- 



Acute Congestion of the Kidneys in Cattle, 217 

ever, unfits the animal for a future vigorous life, and any 
concurrent injurious influence may easily bring on active kid- 
ney disease. 

Lesions, There is redness and swelling of the kidney, it may 
be to two or three times its normal size, the enlargment being 
especially referable to the cortical portion, which may be mottled 
in diflFerent shades of red up to black extravasations. The lack 
of firmness in its connection with its sheath, and the softening 
and friability of the parenchyma resemble the same conditions in 
the horse. The urine may be clear or more or less tinged with 
blood, and contains blood globules, albumen, and crystals of car- 
bonate of lime and urate of ammonia, which seem to indicate the 
presence of a bacterial ferment. 

Symptoms. The patient usually shows some indication of chill, 
with staring coat and arched back, which is very sensitive to 
pinching. There is impairment of rumination and appetite, de- 
crease of milk in dairy cows, uneasy movements of the hind 
limbs and tail, frequent straining to urinate, and the passage 
of urine often in small amount and sometimes of a pink or 
reddish tinge. In bad cases this may become deep red, or 
black, and the pulse becomes weak, with psUpitations, marked 
muscular weakness and a tendency to lie down most of the 
time. 

With early improvement recovery may be complete in from 
four to six days. In the more severe and fatal cases death 
may occur as early as the sixth day. Unless under the in- 
fluence of violent irritants or a persistence of the original poison 
the prognosis is favorable. 

Diagnosis, It is especially important to distinguish this from 
haemoglobinaemia, which shows an uniform red or brown 
discoloration of the urine and an entire absence of blood 
globules as such. In congestion the reddish material tends to 
precipitate and is found to consist largely of blood globules. It 
is further associated with albuminuria. 

Haemorrhagic cystitis and cystic calculi are both chronic 
affections, and identified on rectal exploration by the tenderness 
of the bladder and the presence of the stone. 

Prevention consists in the avoidance of the various causative 
factors, and especially those that find access among alimentary 



21 8 Veterinary Medicine, 

matters. Cattle turned out in early spring should be fed 
before going and should be returned from the pasture in an 
hour or two. This repeated day by day, allows the digestive 
and urinary organs to accommodate themselves to the fresh 
spring grass and to any vegetation to which the animals have 
not been accustomed. Chill, draughts, injuries and other dis- 
turbing conditions must be guarded against. 

Treatment. Bleeding is strongly recommended by Cruzel and 
Cadeac. In Germany, England and America derivation toward 
the digestive organs is more generally relied on. La,xatives 
should be, as in the horse, oleaginous (castor, olive, linseed) or 
manna, rather than agents that may perchance act on the kid- 
neys. Free purgation should be secured. Flaxseed tea, and 
wet compresses over the loins are valuable adjuncts, and anodyne 
agents like camphor, bromide of camphor, or other bromides 
may be added, and when there is any suspicion of infection, salicy- 
lates, or iodide of potassium may be employed. Finally a 
course of bitters (salicin, quinine, nux.) may be employed to re- 
store tone and iron carbonate with sodium carbonate as a recon- 
structive tonic. The diet must be changed to wholesome food» 
but not too stimulating, and the animal kept quiet. 



ACUTE CONGESTION OF THE KIDNEYS IN SHEEP 

AND GOAT. 

Causes : irritant food. Lesions : Symptoms : separates from its fellows, 
arched back, stiff straddling gait,straining, muscular weakness, recumbency, 
urine red, with blood globules and albumen. Prevention : care in feeding 
and watering, change of pasture and treatment as in the ox. 

Causes, As in cattle, the smaller ruminants appear to suffer 
especially from an alimentary renal congestion, showing itself 
mainly in animals that are unaccustomed to the particular 
toxic aliment. Thus, Comevin finds that the Pyrennean sheep 
thrives on the leaves of the Quercus tosa, while Southdown sheep 
taking them in any considerable quantity perish of renal congestion 
or nephritis. Similarly Weith fed four sheep on cynauchum 
vincetoxicum and developed renal congestion in the course of 



Acute Congestion of the Kidneys in Swine. 219 

three days. Other causes doubtless contribute in individual 
cases but have not been specially traced to their effects. 

Lesions are in the main the same as in cattle, the kidneys 
being bluish red, soft, flaccid and friable. 

Symptoms, The sheep lags behind the flock, frequently lies 
down and rises, strains to urinate, and passes often considerable 
quantities. The back is arched, the loins tender, the walk stiff 
and straddling, the pulse small and weak. If the disease ad- 
vances, there come on extreme muscular weakness, a disposition 
to lie, an uncertain, gait, with frequent stumbling, dullness, 
stupor, and it may be coma. The urine is usually tinged with 
blood or of a deep red or black, and contains well-formed blood 
globules and more or less albumen. 

Prevention and treatment should proceed on the same lines as 
in the ox, but in dealing with a large herd it becomes diffcult to 
treat each separate case with special care. The avoidance of 
sudden change of food as in turning out in spring, the feeding of 
grain before turning out, the return to the fold after a short 
freedom, and the gradual transition to the new food are im- 
portant. When the disease has developed, an entire change of 
pasture or food, the use of roots, ensilage, or grain, or of freshly 
cut meadow grass, and an oleaginous' laxative (castor oil 2 to 3 
ozs. ) are indicated. Oilcake or flaxseed meal will often prove 
a most valuable article. Beyond this the same agents would be 
indicated as for the ox. 



ACUTE CONGESTION OF THE KIDNEYS IN SWINE. 

Causes : infection, toxins, fermented food, traumas, crowding, cold. 
Symptoms : stiff loins and quarters, frequent micturition, urine limpid or 
red. Treatment. 

Renal congestion in pigs has been seen mainly as the result of 
toxin poisoning in swine erysipelas, hog cholera or caseous pneu- 
monia. It is also liable to occur from putrid or overfermented 
food, and in fat, heavy animals from injuries sustained in ship- 
ping by rail by trampling on or squeezing each other. KLicks 
and other injuries may at times contribute to its occurrence. 



220 Veterinary Medicine, 

Exposure to cold storms, to which swine are especially sensitive, 
a wet, cold bed, or a leaky roof, are additional causes. 

The Symptoms are more or less stiffness of the loins and hind 
parts, frequent urination, the secretion being often passed in ex- 
cess, and though at times clear yet at others pink and bloody and 
precipitating blood clots or at least containing blood globules. 

Treatment is mainly prophylatic. If therapeutic measures are 
desirable for valuable animals, they should follow the same lines 
as for sheep : rest, fomentation, aqueous food, anodynes, weak 
alkaline diuretics, laxatives, and balsams. 



CONGESTION OF THE KIDNEYS IN CARNi;VORA. 

Causes : acrid diuretics, loss of kidney, catheterization, dermatitis, bums, 
traumas, overexertion. Lesions : enlarged, blood- gorged kidney, red or 
black, petechiated. Symptoms : stiff, arched, tender loins, tardy, dragging 
of hind limbs, urine passed often, clear to bloody, albuminous, anorexia, 
nausea, vomiting, diarrhcea, dullness, stupor. Treatment : stop cause, give 
emetic, laxative, in surgical cases antiseptic, for cantharides, camphor, 
bromides, vegetable food. Warm clothing or building. 

Causes. This comes most commonly from the ingestion of acrid 
or diuretic agents, saltpeter, turpentine oil, cantharides and, 
according to Cadeac, various essential oils including oil of mus- 
tard. It takes place in the remaining kidney after the one has 
been extirpated, or had its functions abolished by disease or 
uretral obstruction. Again, surgical operations on the urinary 
organs, eten the simple passing of a catheter, will cause sym- 
pathetic renal congestion. Extensive acute dermatitis, and bums 
of the skin may have a similar sequence. 

Falls, kicks, blows, or crushing beneath a wheel or otherwise 
are additional causes. 

Finally violent overexertion as in coursing, causes congestion 
with albuminuria, and blood globules and even casts in the urine. 
This is common to the human athlete (who undergoes a violent 
and continued over exertion), also in race and draught horses, and 
dogs. 

Lesions. When congestion is produced experimentally by can- 
tharides the kidneys are found to be enlarged and the cortex 
gorged with blood so that it has a deep red or blackish port wine 



. Nephritis. 221 

hue, with here and there spots of ecclyraosis. The veins capil- 
laries and glomeruli are especially congested, and the epithelial 
cells of the convoluted tubes have become laterally distended, so 
that they approximate to a globular form. A loose coagulum 
containing blood globules may be found in the capsule of the 
glomerulus and in the convoluted tubes. 

Symptoms, These are arching and stiffness of the loins, a 
tardy, dragging movement of the hind limbs and tenderness of 
the loins. The urine may be scanty or in excess, and tends to 
be passed frequently, in small quantities and with evidence of 
pain. It may be clear, pinkish or bloody, and shows albumen 
and frequently casts, and blood globules or small clots. There 
is some impairment of appetite, and, in severe cases, nausea and 
vomiting, with, it may be, diarrhoea, nervous depression, dull- 
ness and stupor. When due to poison or other transient cause 
the symptoms improve when this factor has been stopped. 

Treatment, When due to poison taken by the stomach this 
must be stopped, and the stomach and bowels evacuated by 
an emetic (ipecacuan) and laxative (sodium sulphate). Appro- 
priate treatment must be made in case of burns or skin eruptions. 
When surgical cases are due to infection rather than simple 
shock or sympathetic irritation, antiseptic injections of the 
bladder are indicated. In all cases alike a warm bath is an im- 
portant adjunct. When irritation is due to cantharides, it may 
be calmed by camphor, 2 grains every three or four hours. 
Other anodynes may be given as required. Rest is essential and, 
as appetite is recovered, a moderate amount of amylaceous pud- 
dings. A warm building or comfortable clothing is desirable. 



NEPHRITIS. 



The renal iuflammations have not been fully investigated in the 
domestic animals, and even in man, the pathology of several of 
the forms is still enveloped in some measure of doubt. In man 
the following conditions have been noted : 

1st. Acute parenchymatous nephritis with enlarged kidney and 
degenerated tubules. 



222 Veterinary Medicine, 

2d. Chronic parenchymatous nephritis with enlarged kidney and 
degenerated tubules. 

3d. Acute diffuse {^desquamative ^ interstitial) nephritis with en- 
larged kidney and glomeruli, tubules and connective tissue degen- 
erated. 

4th, Chronic diffuse (^desquamative, interstitial) nephritis, 

5th. Suppurative nephritis and pyelo-nephritis, infection may 
be from injury. 

6th. Peri-nephritis : infection of connective tissue with adjacent 
disease. 

In domestic animals the following distinctions have been made : 

I St. Acute nephritis, 

2d. Chronic nephritis. 

3d. Purulent nephritis and pyelo-nephritis, 

4th. Peri-nephritis. 



ACUTE NEPHRITIS. ACUTE BRIGHT'S DISEASE. 

Animals affected. Causes : hyperaemia, traumas, cold, chill, fever, bac- 
teria, toxins, overfeeding, nitrogenous food, ra«¥ potatoes, xanthin products, 
acrid diuretics, diuretic insects, suppression of micturition, skin lesions, 
bums, embolism, calculus. Symptoms : colic, trembling, rigor, arched, 
stiff, tender loins, stiffness in quarters, drags hind legs, urination frequent, 
movements of penis and testicle, costiveness, grinding teeth, anorexia, 
vomiting (in dogs, cats and pigs), fever, dropsies, ursemic convulsions^ 
urine scanty, high colored, red or bloody, thin, cloudy or turbid, albumi- 
nous, purulent, oxalates, urates, hippurates, hsematoidin, epithelium, 
mucus, casts. Prognosis : resolution in three days, or ursemia, suppuration, 
degenerations. Lesions : kidney enlarged, softened, friable, red, yellow, 
black, purulent, glomerulitis, tubular hephritis, interstitial nephritis. Treat- 
ment : rest, warm building, warm clothing, green or sloppy, amylaceous 
food, bleeding, cupping, skin friction, fomentations, warm bath, hot air 
bath, sinapisms, anodynes, laxatives, diaphoretics, heart tonics, alkaline 
diuretics, paracentesis, bitters, iron, phosphates, hydrogen peroxide, cubebs, 
etc. 

Genera affected. This has been seen in horse, ox, dog, sheep 
and pig. 

Causes. It is ascribed to the most varied causes, such as : 
hyperaemia, blows and injuries on the back and loins, sprains of 



Acute Nephritis. Acute BrighVs Disease, 223 

the loins, abrupt wheeling when in galop, exposure to cold winds, 
and storms, especially when perspiring and fatigued, sudden sup- 
pression of perspiration, extreme terror, bacterial infection and 
infection by toxins (in septicaemia, pyaemia, influenza, contagious 
pneumonia, uterine sepsis, omphalitis, infectious angina (Fried- 
berger), bronchitis (Siedamgrotzky), glanders, tuberculosis. 
Among dietary causes are named : a rich nitrogenous food 
(grains, beans, peag, vetches, cotton seed, clover), raw potatoes 
in excess, cotton seed meal, agents that increase the nitrogenous 
and xanthin bodies in the urine. 

Dr. Alfred C. Croftan, in his experiments with xanthin 
bodies on rabbits, found that xanthin and hypoxanthin pro- 
duced great increase of arterial pressure, atheromatous changes 
in the vessel walls consisting in thickening of the intima, with 
small celled infiltration and necrotic changes in different areas of 
the vessel walls. This in the kidney produces the primary inter- 
stitial form of nephritis known as gouty kidney and associated 
with retention of uric acid and other xanthin bodies. The 
accompanying cardiac hypertrophy, so common with such kid- 
neys, he attributes to the increased intravascular pressure. 

Irritant vegetables that are resinous or diuretic, and irritant 
diuretic insects are incriminated (cantharides, caterpillars in 
grass, or on plants, etc., lice on cabbages particularly, — Cruzel, 
Neubert). Irritant drugs that are eliminated by the kidneys 
have been equally charged (tar, carbolic acid, iodoform, chlorate 
of potash, nitrate of potash, phosphorus, arsenic, lead, mercury). 
Compulsory suppression of micturition is undoubtedly injurious 
in house dogs shut up, mares kept long in harness, or horse on 
railway car, above all if this follows a diuretic or drinking 
abundantly. In such cases it is altogether probable that bacteria 
already exist in the blood or kidneys and take occasion to attack 
the tissues weakened by the overdistension or other inimical 
cause. This is all the more probable seeing that the kidneys are 
a favorite channel for the elimination of bacteria present in the 
system. It should be noted that nephritis is liable to supervene 
on extensive skin bums, chronic dermatitis and other skin 
diseases. vSome cases are traceable to embolism, the clots coming 
from the lungs, heart or arteries, in others the irritation is due to 
calculi in the renal pelvis or tubules, and their attendant bacteria. 



224 Veterinary Medicine, 

These are especially common in cattle that are winter fed on dry- 
food. Again, the infection may have travelled forward through 
the ureters from a pre-existing infective cystitis. 

Symptoms, There may be obscure or intense colic ; trembling 
or rigor may occur, yet is often omitted or unobserved ; the loins 
are arched ; the hind feet are advanced under the belly, or there 
is frequent shifting of the weight from one foot to the other; the 
walk shows stiffness of the back and hind limbs which appear to 
straddle or drag behind ; urination is frequent in small amount, 
or there are frequent inffectual attempts to urinate ; the patient 
is indisposed to lie down, and if he does so it is carefully, with 
difficulty and groaning ; the testicles are drawn up and dropped 
alternately, the penis is often protruded from and retracted 
within its sheath, the loins are sensitive to pinching, percussion^ 
or electric current ; when mounted the animal drops under the 
weight ; he carries the head low and refuses to go fast. In bad 
cases there is constipation, grinding of teeth, anorexia, and in 
dogs, vomiting. Temperature may be normal or there may be 
considerable fever. Dogs may lie curled up, with occasional 
tremors. Dropsical effusions are frequent in the form of anasarca 
under the chest or abdomen, or beneath the lower jaw, or as 
stocking of the limbs, or the effusion may occur into an internal 
serous cavity. Convulsions may occur from brain poisoning by 
urea or other retained urinary product. 

In. the slighter forms the severe symptoms may be absent, and 
the condition of the urine must be investigated as affording the 
most constant and characteristic phenomena. 

The urine is usually scanty, high colored, of a high specific 
gravity and is passed often with pain and groaning. At the out- 
set of an acute attack it may be bloody ; later it may be only 
cloudy or turbid from the excess of epithelial and pus cells,, 
leucocytes, salts and albumen. Early in the disease the casts 
may contain red blood cells, and renal epithelium, later leucocytes, 
nuclei, granules, pus cells, crystals and other matters. Albumen 
is usually abundant as demonstrated by boiling and nitric acid. 

Soda carbonate crystals ^ rhomboid, rosette-shaped or spherical 
and effervescing with acetic acid, abundant in normal herbivorous 
urine, may be greatly reduced or absent in nephritis. 

Soda oxalate crystals, tetrahedral and insoluble in acetic 



Acute Nephritis, Acute Bright* s Disease. 225 

acid, and normal in herbivora and camivora, are increased if the 
urine is acid as in severe nephritis, but also in rheumatism, te- 
tanus, septicaemia, angina, heaves, and other affections with de- 
fective aeration of the blood. 

Ammonio-magnesian phosphate crystals, rhomboid but' 
insoluble in acetic acid, are found in alkaline (ammoniacal ) or neu- 
tral urine, and appear to be often due to intestinal fermentations. 

Cystine crystals, flat hexagonal plates, precipitated in healthy 
urine, but dissolved by ammonia are absent in retained and fer- 
mented specimens. 

Uric acid crystals, rhomboids and plaques, brick red, and 
normal in the urine of carnivora and flesh-fed omnivora, may be 
present in herbivora not only in acute nephritis, but in other ex- 
tensive inflammations attended with anorexia and the consump- 
tion of the animal tissues. 

Hippuric acid crystals, right rhombic prisms and their de- 
rivatives, and insoluble in hydrochloric acid or ether, are greatly 
increased in all febrile diseases in herbivora, nephritis included. 

Haematoidin crystals, fine needles or bundles of the same, 
yellowish red, are found in nephritis, haematuria, heaves, etc. 

Epithelium, if columnar, points to disease of the kidney 
tubes, though very similar cells are derived from the urethra in 
both male and female. Squamous epithelium points to the cystic 
mucosa and is not increased in nephritis. 

Mucus in cylindroid form may point to nephritic congestion or 
inflammation, but this may be present in health, and may show 
in irregular masses derived from the renal pelvis or the bladder. 
Mucous casts are always extremely elastic and mobile, and lack 
the even clear cut margins of the casts of nephritis. They are 
much more common in horse's urine than in that of other animals. 

Tube casts are especially indicative of nephritis and exuda- 
tion into the uriniferous tubes. They are much firmer than the 
mucous cylinders and have smoother and more even margins. 
If relatively thick and straight they probably come from the 
straight tubes ; if sinuous or twisted, from the convoluted tubes. 
With a similar basis substance they often enclose different solid 
bodies and have been named accordingly : — epithelial casts 
when containing cylindroid, or polyhedral cells may be unhesi- 
tatingly referred to the uriniferous tubules : — granular casts in 
15 



226 Veterinary Medicine, 

which the homogeneous cast is impregnated with granular cells 
and free granules of proteid, fatty, or mineral matter, point 
directly to inflammation affecting the uriniferous tubules and 
their epithelial lining : — ^blood casts enclosing red blood globules 
Imply hemorrhage, or congestion or inflammation of the tubules, 
with blood extravasation or diapedesis : — casts containing 
leucocytes and pus cells bespeak suppurative inflammation of 
the tubules : — calcareous casts entangle numerous crystals and 
granules, mainly of lime carbonate, and effervesce with acetic 
acid : — ^hyaline casts are homogeneous, clear, so transparent 
that it is sometimes necessary to stain them with iodine or ani- 
line to make them distinct ; they are found in nephritis and 
especially in the chronic forms : — colloid casts or waxy casts, 
or amyloid casts may designate a class of firmer cylinders, 
clear, homogeneous and refractive, and often bearing fatty, or 
blood globules, crystals or fungi. They may have a yellow 
color, or they may give the amyloid mahogany reaction with the 
iodo-potassic iodide solution (even in the absence of amyloid de- 
generation of the kidney ; Jaksch). 

Progress. Acute nephritis may advance for three days or more 
and then terminate in resolution, or go on to complete anuria 
with coma, to suppuration, gangrene or chronic nephritis. 

Resolution is marked by general improvement of pulse, 
breathing and expression, clearing of the urine, and return of 
appetite. The urine may remain albuminous for eight days 
longer. 

Complete suppression of urine has persisted five days in 
cattle (Funk), and seven days in horses (Friedberger), accom- 
panied by intense fever, dullness, stupor and coma ending in 
death from uraemia. 

Purulent urine is white, milky, albuminous, granular, with 
epithelial cells and casts and pus cells, showing their double nuclei 
with acetic acid. There are usually rigor, hyperthermia (io6® 
F.), thirst, intermittent colics, diarrhoea, perspiration, uncertain 
walk, and stocked legs. Convulsions have been noticed in the 
horse (Didie), cow (Pflug) and bitch (Trasbot). The horse may 
turn in a circle (Friedberger) or have amaurosis (Didie). Death 
usually occurs in two weeks, 

Gangrene is likely to prove fatal. Berger has seen death oc- 



Acute Nephritis, Acute Bright' s Disease. 227 

cur in three days in the horse, and Trasbot in four days in a cow, 
after a large cantharides blister. 

Pathological Anatomy, The kidney is enlarged, soft, friable, 
dark red, yellow with red spots, or having areas of hemorrhage. 
When fatty it is marbled, pale yellow or white and red. The cap- 
sule is easily detached. On section it is bloody, oozing or even 
dropping blood, or a pale creamy fluid. The pelvis contains 
urine, thick, gelatinoid, bloody or purulent. The latter condi- 
tion must not be confounded with the thick pus-like mucus which 
normally occupies the renal pelvis in the horse. 

The lesions of the secreting portions of the kidney will vary 
with the concentration of the inflammation in one or other of 
the separate tissues. 

In glomerulitis from toxic irritants, the capsules enclose an 
albuminous liquid exudate, the capillaries are overdistended, 
their walls thickened and cloudy, and thrombi with an excess of 
red globtdes and leucocytes block them at intervals. This capil- 
lary obstruction extends to the plexus surrounding the convoluted 
tubules. 

In tubular nephritis there is congestion of the plexus cover- 
ing the convoluted tubes, and the epithelium shows cloudy swell- 
ing, with fatty granules and hyalin droplets in the desquamating 
cells. 

With interstitial nephritis there is an exudate into the in- 
terstitial connective tissue between the tubules, and into the 
tubules forming hyaline casts. The epithelium of the tubules are 
swollen, granular, opaque and desquamating. 

In suppurative nephritis may be found all stages of ab- 
cedation from minute points, gray or yellow, and only just visible 
to the naked eye, in the midst of the deep red congested tissues, 
through the larger white suppurative areas, to the extensive 
abscess formed by a coalescence of the many, the intervening 
tissue having broken down by a necrotic disintegration. In the 
earlier stages the pus infiltrates the parenchyma so that it may be 
comparable to a sponge filled with this liquid. 

Treatment. The first consideration is rest, with a warm build- 
ing or clothing to solicit the action of the skin and lessen the 
work of the kidneys. Warm summer weather is favorable, or 
we should secure a sunny, comfortable, loose box, or a building 



228 Veterinary Medicine, 

heated by a stove. In default of this, warm woolen blankets, 
hood and leg bandages should be secured. If the case is mild 
enough to allow of appetite, the food for herbivora may be green 
food in summer and carrots, beet, turnip, potato or ensilage in 
winter. The dog may have buttermilk or sweet milk or mush 
and milk. Meat is objectionable because of the amount of urea 
and other urinary products which it produces. 

Trasbot strongly recommends general bleeding in strong, 
vigorous horses and cattle, attacked by the disease in an acute 
form, but deprecates it in the lymphatic, fat, or debilitated. 

Omitting the general bleeding, one can always find a good and 
safe alternative in bleeding the animal into his own tissues. 
Shaving the loins and cupping has often an excellent effect. An 
approach to this may be had by vigorous rubbing by several men 
at once, of the limbs and the whole surface of the body, by warm 
fomentations over the loins by means of spongio-piline or sur- 
geon's cotton covered with dry blankets, or by winding a hose 
round the body through which warm water is forced, or finally 
by a bath of steam or hot air, or in small animals of warm water. 
The dog may be placed in a bath of 80** or 90° F., which is al- 
lowed to gradually cool to 65° or 70°. In all these cases the 
greatest care must be taken to avoid chill when the animal is 
taken out. He should be quickly rubbed dry in a warm room 
and blanketed. 

Counter-irritants act in the same way, and mustard, or hot 
water hotter than the hands can bear may be applied. Turpen- 
tine, cantharides and other diuretic counter-irritants must be 
carefully avoided. An old practice of la3ring a freshly removed 
sheep skin over the loins, with the flesh side inward, often causes 
a distinct exudation, thickening of the skin and derivation. 

A damp cloth, laid across the loins and thoroughly covered 
with dry to prevent any evaporation and chill, will usually give 
great relief and may be kept on for days. 

Internal medication must at first be mainly anodyne, laxative 
and diaphoretic. The two latter classes are at once derivative 
and eliminating, carrying out through other channels, waste 
products that would otherwise have taxed the kidneys. 

Among anodynes, the bromide of camphor (horse, 1-2 drs., 
dog, 2 to 5 grs.), bromide of potassium (horse, i dr., dog, i to 3 
grs.) or hyoscyamus may be used, and repeated twice daily. 



Acute Nephritis, Acute Bright' s Disease. 229 

Purgatives must be restricted to such as have no tendency to 
act on or irritate the kidneys. Castor oil, or sweet oil for the 
larger animals, or for the dog senna or jalap, may be given every 
morning to secure free movement. 

As diaphoretics, ipecacuan, Dover's powder, tartar emetic and 
even pilocarpin may be used. The last named agent is especially 
useful when dropsy sets in, or uraemic stupor or coma threatens 
(horse 3 g^., ox 7 grs., dog i to ^ g^. according to size). If 
the heart shows weakness it must be sustained by digitalis, 
strophanthus, caffein or nitroglycerine, and the pilocarpin with- 
held. 

In a sufficiently strong subject the stupor or coma may be met 
by the abstraction of blood, which benefits by the dilution of that 
which is left. 

Eclampsia may be further met by the inhalation of ether or 
chloroform, or the rectal injection of chloral or bromide solution. 

As the inflammation abates, if the action of the kidney is still 
insufficient in spite of the free drinking of pure water, alkaline 
diuretics may be given in small doses (tartrate, acetate or citrate 
of potash, bicarbonate of soda, saltpeter). 

In excessive dropsy avoid sloughing by lancing the most tersely 
swollen parts to allow drainage, and keep the parts disinfected 
with carbolic or other antiseptic lotion. For ascites or hydro- 
thorax, aspirate, and apply a compressory bandage. 

During convalescence a course of bitters (cinchona, salicin, 
gentian, nux vomica) and iron (phospho- tartar, iodide or phos- 
phate) will often be called for. Anaemia may be met by doses of 
peroxide of hydrogen or the inhalation of oxygen. 

In the advanced stages benefit may accrue from the use of 
small doses of cubebs, copiaba, oil of turpentine or buchu, which 
liave a tonic action on the renal mucosa. 



PURULENT NEPHRITIS. 

Causes : general, traumatic, metastatic, infective, wounds, shocks, strains, 
blows, falls, crowding, heavy loads, calculi, infective embolism. Lesions : 
miliary or large abscessea, diffuse suppuration, softening, disintegration, 
fistula. Symptoms : obscure, nephritic symptoms following distant abscess, 
chill, hyperthermia, (general symptoms 6f nephritis, pus in urine, ansemia, 
emaciation. Treatment : to external wound, antiseptics, evacuate abscessi 
extirpate kidney with pyonephrosis, in dog or pig, calcium sulphide, sul- 
phites, copiaba. 

Causes, Aside from the main causes of nephritis, the sup- 
purative form may be determined by traumatic or metastatic 
infective conditions. Under traumatic factors may be named 
punctured or gunshot wounds, shocks and strains connected 
with falls, blows, crowding, compression, too heavy weights on 
the back (pack, rider, two wheeled cart loaded too heavily 
forward and going down hill), and finally calculi in the urini- 
ferous tubules. Under metastatic factors come all infections, 
pyaemia, omphalitis, any suppurative affection of the lungs> 
(abscess, pneumonia, broncho-pneumonia), pharangitis, etc. 
Embolic renal abscess may start from endocarditis, arteritis, or 
ptdmonary phlebitis. 

Lesions, There may be a circumscribed renal abscess like a 
good large orange, or many small gray spots like millet seeds, 
peas or hazel nuts, having purulent centres and containing pus 
cocci or bacilli. In other cases a diffuse inflammation suppur- 
ates throughout till the whole gland becon^es a pulpy mass of 
pus, blood and broken down kidney tissue (pyonephrosis). 
In traumatic cases the pus centres around the wound or injury, 
perhaps invading adjacent parts, and even communicating 
through the skin externally along the line of the original wound. 
The pus may burrow in different directions in the cortex or 
under the capsule with abscess at intervals (perinephritis), or 
along the vessels to the medullary structure. 

Symptoms. These are often obscure. The sudden appearance 
of kidney disease in the course of a suppurative affection else- 
where, the extension being ushered in by a chill or rigor or 
attended by a succession of these, and the course marked by 
230 



Purulent Nephritis, 231 

a variable hyperthermia is very suggestive. StiflFness and weak- 
ness of the hind parts and tenderness of the loins are sigifi- 
cant ; also, in camivora and omnivora, nausea and vomiting. 
When the kidney can be felt by the hand in the rectum or in 
the small animals, through the flaccid abdominal walls, the 
manifest enlargement, the tenderness, and in some cases even 
fluctuation will assist in diagnosis. In such cases, puncture by 
a large h3rpodermic needle, or a small trochar may betray the 
presence of pus and complete the diagnosis. If the pus escapes 
i^to the pelvis of the kidney it may be recognized in the urine. 
The case is very liable to become chronic, and is then marked 
by anaemia and emaciation. 

Treatment. When an external wound exists it must be treated, 
antiseptically, with boric acid, potassium permanganate, or other 
antiseptic lotion. If a single large abscess exists, puncture evac- 
uation through needle or trochar, and washing out with an anti- 
septic solution is the obvious resort. Any foreign body must of 
course be removed. If the suppuration is diffused through the 
whole mass of softened kidney, the resort of extirpation may be 
considered. This is always dangerous as provocative of infec- 
tious peritonitis, but it is less so in dogs and swine than in other 
animals owing to their natural antagonism to pus microbes. The 
operation should be attempted extraperitoneally, the incision be- 
ing made beneath the anterior lumbar transverse processes and 
carried inward through the sublumbar connective tissue. The 
renal aftery will require ligature with antiseptic catgut and all 
manipulations should be aseptic or antiseptic. Even if successf td, 
this operation leaves the subject in a dangerous state, as in case 
of kidney disease at any future time, there is no second kidney 
to compensate for the temporary loss of function and uraemic 
poisoning is to be dreaded. 

Apart from surgical measures the general treatment would be 
largely the same as for acute infectious nephritis. As antiseptics 
calcium stdphide, the different sulphites, copiaba, etc., will be 
indicated. 



PERI-NEPHRITIS. 

Definition. In cattle on low damp lands, acrid plants, sprain, blow, cal- 
culus, from pumlent nephritis, in aneemia. Symptoms : of nephritis, soil- 
ing of tail or prepuce, albumen, pus or blood in urine, lameness, unilateral 
or bilateral, lumbar swelling, in small animals fluctuation, history. Lesions : 
abscesses around kidney, under capsule, intercommunicating. Treatment : 
as in purulent nephritis. 

Suppuration in the connective tissue between the kidney and 
its capsule is seen in cattle in low conditioii, on damp, un- 
improved soils like undrained river bottoms and estuaries, 
abounding in acrid and diuretic plants. Even among such ani- 
mals it is rare and has probably a directly exciting cause in a 
sprain< or blow on the loins, or the presence and movement of a 
renal calculus. It may extend from suppurations in the sub- 
stance of the kidney and to such extension the weak or anaemic 
condition materially contributes. In man, in which such condi- 
tions have been more frequently observed, a weak or cachetic 
condition is considered as an essential accessory factor along with 
the traumatic lesion (R. Harrison). Similar conditions may be 
expected to bring about peri-nephritis in any one of our domestic 
animals. The author has observed it especially on the low lands 
on the banks of the Ouse in Yorkshire, England. 

Symptoms, These are mainly those of nephritis in general, 
shivering, sti£F movement in the hind limbs, straddling, frequent 
passage of urine, straining, difficulty in lying down and rising, 
tenderness of the loins, dropping when mounted, groaning when 
turned in a short circle. If the suppuration communicates with 
the pelvis of the kidney there may be, in females, soiling of the 
tail, and in males of the prepuce. Blood may be passed with the 
urine, and pus cells and albumen are found when it is examined. 
If one kidney only is aflFected, there is lameness in the corre- 
sponding hind limb, the special feature being inability to extend 
it backward. A swelling on the one side of the loins, and be- 
neath the lumbar transverse processes ji'st posterior to the last 
rib, is likely to be a marked symptom, and if this persists and is 
especially prominent at one point, an exploratory incision or 
232 



Pyelitis, Pyelo-nephritis, Inflammation of the Renal Pelvis. 233 

puncture will detect the presence of the pus. Fluctuation can 
rarely be detected, yet in small animals with very flaccid ab- 
domen, the swollen, tender kidney and even fluctuation should 
be detected at times. The history of the case, the low, damp 
pasturage, the access to acrid plants, the alimentation with hay 
or grain covered with cryptogams, the fact of an injury and the 
low, weak, anaemic condition of the animal should contribute to 
a satisfactory diagnosis. 

Lesions, In bovine kidneys aflFected in this way we have found 
general inflammation and exudation around the entire kidney and 
inside the capsule, with numerous small abscesses, in many 
instances communicating with each other. They may extend 
through the capsule and invade surrounding organs. 

Treatment, In the treatment of cases of this kind the general 
principles of therapeutics for nephritis are about all that can be 
attempted in the lower animals. Fomentations over the loins are 
especially desirable as a means of relieving the suffering, and 
moderating inflammatory action. To the same end is the allow- 
ance of plenty of pure water as a diluent. Then the various 
agents that antagonize suppuration may be thought of, and some 
one selected for use. Beside the antisuppurants already men- 
tioned one may use copiaba, cubebs, or turpentine in small doses, 
salicylates, or the sulphide or sulphite of calcium. Surgical inter- 
ference by puncture or incision and antiseptic irrigation can only 
be thought of when the abscess is single and circumscribed ; never 
when the whole periphery of the organ is involved. In the latter 
case the only rational surgery would be the desperate resort of the 
removal of the entire kidney. 



PYELITIS. PYELO-NEPHRITIS. INFLAMMATION OF 
THE RENAL PELVIS. 

Definition. Canaes : primary from vegetable irritanta in food, toxina, 
cryptogama, pelvic calculua, strongylua gigas ; secondary from renal calcu- 
lus, parasite, tubular uretral or vesical infection, infecting deposits, metasta- 
sis. Symptoms : as in nephritis, pus, blood, or albumen in urine, tender, 
arched loins, purulent polyuria, with spheroidal epithelium. Diaj^osis. 
Lesions: inflammation, calculus, etc., in pelvis. Treatment: pure water, 
aodium bicarbonate, antiseptics, bslsams, fomentations, piperazin, extraction 
of calculus. 



234 Veterinary Medicine, 

Suppurative inflammation of the mucosa lining the renal pelvis 
may occur in the acute or chronic form. 

Causes. It may be either primary or secondary. As a primary 
disease it may be the result of poisoning by irritant diuretics such 
as cantharides, turpentine, colchicum or balsams, or shoots of the 
coniferae, it may be due to the passage of the irritant products of 
cryptogams found in musty fodder, or grain, or it may come from 
the irritation caused by the toxins of bacteria developed in the 
system or in food or drink. Cases that develop from the irritation . 
of a pelvic calculus or precipitate, and from the presence of the 
strong^lus gigas (in dogs) may also be placed in this class. 

As secondary causes are those in which the inflammation start- 
ing in the uriniferous tubes extends down to and implicates the 
pelvis, and the still more frequent instances of extension of puru- 
lent infection upward from the ureter, bladder or prostate, so as to 
involve the pelvis. So in blocking of the urethra by strongylus, 
stricture, clot or calculus, and in spasm of the sphincter vesicae, 
the delayed urine is liable to undergo fermentation with evolution 
of ammonia, and not only the bladder but the ureter and renal 
pelvis may suffer. Again, the occurrence in the kidney of the 
hyperplasia of cancer, glanders (horse) and tuberculosis (cow) 
may be the direct cause of pyelitis. Similarly foci of infection in 
the kidney may be found in distemper in the dog, and in the con- 
tagious pneumonia and influenza of the horse. In man infection 
from the bowel through the migration of the bacillus coli com- 
munis to the devitalized kidney and contents in hydronephrosis, 
has been trsiced, and the liability to this must be still greater after 
the surgical insertion of the ureters in the rectum as a substitute 
for the obliterated bladder and urethra. Again, in the intra-ar- 
terial migrations of the strongylus (sclerostoma) armatus pus 
microbes may be carried to the kidney and reach the pelvis. 

Symptoms, These are in the main those of nephritis with 
marked rigors. The presence of pus cells and albumen in the 
urine may come from suppuration in the substance of the kidney 
itself, or sub-capsular abscess opening into the pelvis, or it may 
come from cystitis, prostatitis or urethritis. The special stiffness 
and tenderness of the loins, polyuria in which the liquid is puru- 
lent, but free from uriniferous casts, and in which it is charged 
with the spheroidal epithelium of the pelvis (not the columnar of 



Pyelitis. Pyelo-nephritis, Inflammation of the Renal Pelvis. 235 

the tubules), may afFord presumptive evidence of pyelitis. But 
pyelitis is usually combined with nephritis or cystitis and the com- 
plications prevent diagnosis. In some cases the urine is scanty 
and strongly albuminous, and in others a round calculus will 
block, at intervals, the opening of the ureter giving rise to 
obstruction of the flow from that kidney and the occurrence of 
violent renal colic lasting until the stone i^ again dislodged back- 
ward. 

Diagnosis cannot often be certain. Purulent urine, with a 
considerable number of the spheroidal cells of the pelvis, and the 
general signs of nephritis may be taken as diagnostic. A great 
excess of such epithelial cells would on the contrary point to 
cystitis. 

Lesions. In the early stages the mucosa of the pelvis is con- 
gested, red, aud sometimes, with calculus, haemorrhagic. Later 
it becomes thickened by exudate, which fills also the submucous 
tissue. In some instances the pelvis is distended by an impacted 
calculus, in others the obstruction of the ureter by an impacted 
calculus or a swelling has led to overdistension of the pelvis, and 
ammoniacal fermentation of its contents. Coincident inflamma- 
tory lesions of the kidneys, ureter, or bladder are common. 

Prognosis is not hopeful. Where it has resulted as a descend- 
ing infection from the kidneys, the severity of the primary lesion 
renders the case a grave one, while if it has been an ascending in- 
flammation from the bladder it is no less so. 

Treatment. Diluent (watery) diuretics are especially indicated. 
Pure water may be given ad libitum. To this may be added if 
necessary moderate doses of bicarbonate of soda or potash with 
such non-irritating antiseptics as salicylic acid, salicylate of soda, 
sulphite of soda, sulphide of calcium, quinia or chamomile. Tras- 
bot even recommends small doses of vegetable astringents, balsam 
of Tolu, or Peru or of Copiaba, or oil of turpentine or tar water. 
Apart from simple water, the diuretic agents may be used with 
greater freedom if the solid parts of the kidney are little or not at 
all involved and if the urine contains no casts of the uriniferous 
tubes. 

Benefit may also be obtained from fomentations, or cupping of 
the loins, and even from the application of mustard and counter- 
irritants. 



236 Veterinary Medicine, 

If the active symptoms subside the continued use of tonics 
would be indicated, especially quinia, and also of the balsams with 
the view at once of antisepsis and toning up of the mucous mem- 
brane. 

In case of calctdus of the pelvis surgical extraction is virtually- 
the only resort, though a very desperate one. Its increase may 
be retarded or prevented by antisepsis, a liberal use of water, and 
the exhibition of piperazin or some of the essential oils. 



CHRONIC NEPHRITIS. 

Cases destroyed as eating their heads off. Causes : sequel of acute nephri- 
tis, swill, lead, experimentally, microbian invasions, toxins, metastatic em- 
bolism, extension from aortic disease, sclerostoma, nitrogenous overfeeding, 
toxins of putrid food, or cryptogams, valvular disease of the right heart, 
rheumatism, heaves, calculus, starvation, debility, retention of urine. 
Symptoms: emaciation, flabby muscles, lack of vigor, stiff loins and 
quarters, short step, straddling, fatigue under slight exertion, groaning in 
trot, or in turning, droops when mounted, slow to rise on hind limbs, poor 
capricious appetite, anaemia, stocked legs, dropsies, urine of lower density, 
albuminous, with granular epithelium and casts, abundant in early stages, 
scanty with weakened heart and degenerated kidneys. Secondary palpita- 
tions, bronchial catarrh, pneumonia, hemorrhage, stupor, lethargy, vertigo, 
etc. Lesions : recent cases, kidney large, cortex firm, capsule adherent, 
with fi^ranular fatty debris, and tubular casts ; old cases, kidney contracted, 
fibroid, glomeruli and tubules atrophied. Bronchitis, pneumonia, hepatic 
cirrhosis, heart enlarged, fatty, dilated, iuhufficient valves. Prognosis un- 
favorable Treatment : gentle exercise, warmth, succulent food, amylaceous, 
tonics, iron, bitters, mineral acids, heart tonics, for polyuria bromides or 
iodides, balsams, pilocarpin. fomentations or sinapisms to loins. 

Chronic nephritis has reeeived little attention in the lower ani- 
mals for various reasons. The lower animals largely escape the 
causative factors of alcholism and chronic lead and copper pois- 
oning, and when suffering from any chronic affection that dis- 
qualifies the animal for use and renders it anaemic and emaciated 
it is naturally sacrificed to save the cost of maintenance. In spite 
of this a considerable number of cases have been recorded in 
horses, and cattle and especially in dogs and cats. 

Causes, Cases of acute nephritis sometimes improve and give 
promise of recover}' without completing the work of convalescence. 



Chronic Nephritis, 237 

Trasbot notes such cases in the dog, and Dickinson in the ox. 
Alcoholic nephritis and degenerations are to be sought for espe- 
cially in cattle kept on distillery and brewery dregs. Lead taken 
in small quantities in soft water that has run through lead pipes 
or stood in leaden cisterns produces in cows and other animals 
chronic a£Fections of the kidney. EUenberger and HoflFmeister 
have produced the disease experimentally with lead and copper 
respectively. 

Microbian invasions of the kidney that advance slowly like 
glanders and tubercle are further causes of chronic nephritis. 
Other secondary microbian infections of the kidney are complica- 
tions of infectious diseases in other parts, including abscess, 
pyaemia, septicaemia, ulcerative endocarditis of the left heart, 
bronchitis, pneumonia, (Frohner), and of others less directly in 
the line of the circulation, as omphalitis, uterine phlebitis (Lustig), 
abscess of the nasal sinuses, bones, and fistulae (Trasbot). 

In other cases the nephritis is evidently a result of the irritation 
caused by toxins in process of elimination by the kidneys, as 
there is no evidence of a nephritic infection. 

In some instances minute emboli originating in the lungs or 
heart, become the starting point of the nephritis, which slowly 
extends by reason of infection or low condition and special sus- 
ceptibility. Disease of the aorta or renal artery may lead to this 
condition as noticed by Cadeac and Lustig. Cadeac has also 
noticed its association with aneurism of the mesenteric arteries so 
that the strongylus (sclerostoma) armatus may be considered as a 
factor. Again in old horses and dogs it has been associated with 
atheroma of the aorta and renal vessels (Trasbot). 

Overfeeding is not without its influence, especially when on ani- 
mal food, which charges the kidneys with excreting an excess of 
the irritating urea and uric acid, and this is one reason why it is 
far more frequent in house dogs than in other domestic animals. 
When the meat is already decomposing and putrid there is the 
added evil of a quantity of toxins and even of microbes to be elimin- 
ated from the system by the much abused kidneys. Add to these 
that the dog*s urine is even in the normal condition more dense 
and contains more irritating ingredients than that of herbivora, 
and that owing to the slight activity of his perspiratory apparatus 
he can obtain less relief from the skin, and we find a substantial 
ground for the prevalence of chronic nephritis in this animal. 



238 Veterinary Medicine, 

Disease of the valves of the right heart or dilatation with in- 
suflSciency of the auriculo- ventricular valves is a potent cause of 
nephritis, the reflux of blood into the veins and the increased 
venous tension, speedily producing passive congestion and a slow 
type of inflammation in the kidney. This factor is especially 
liable to operate in dogs, which are particularly obnoxious to 
rheumatism and valvular ulceration, and are very subject to 
nervous cardiac disorders ; in horses that have contracted heaves ; 
and in beef breeds of cattle which suffer from fatty degeneration 
of the heart with dilatation. 

The influence of calculi must not be overlooked, whether they 
are lodged in the pelvis, the chalices, or the uriniferous tubules. 
Their tendency is to induce local irritation and exudation, with 
fibroid degeneration and thickening of the walls of the tubules or 
pelvis and of the adjacent tissue. 

When to one or more of the above conditions there are added 
overfeeding or what is worse a low condition from starvation or 
unwholesome food (permeated by bacteria or cyptogams or con- 
taining vegetable acids), and when to crown all there are fre- 
quent exposures to cold or wet, we have a vicious combination 
especially conducive to kidney trouble. 

Habitual retention of urine in mares in harness, in house dogs, 
or in horses in railway cars, and violent exertion, or sprains of the 
back are among the remaining accessory causes. 

Symptoms, These are often slight or obscure, so that not only 
owners and attendants but even veterinarians are liable to over- 
look them. Loss of flesh, flabbiness of the muscles and a lack of 
spirit and energy are among the first symptoms. The horse ap- 
pears stiff, especially in his loins and hind limbs, and fails to ad- 
vance the hind feet as far under the belly as formerly, and 
straddles more. When put to work he is early fatigued and ap- 
pears unfit for sustained exertion. His movements are slow and 
if urged to a trot he may even groan with every step and quickly 
settles back to his sluggish pace. If turned sharply round on 
himself he does so with difficulty and often groans. When he is 
mounted or when the loins are pinched he may droop to excess. 
If you come on him lying down, and urge him to rise he may 
rise on his fore limbs and sit on his haunches until urged before 
he makes any attempt to raise himself on his hind. The dog may 



Chronic NepkriHs, 239 

spend most of his time in the kennel, and show little disposition 
to run, play or hunt. On the contrary the owner may have to 
call him several times before he will come out and then he moves 
listlessly, wearily and even weakly. 

In all animals the appetite is poor or capricious, and the 
patient gradually loses condition, at first slowly and later, after a 
few weeks or months, more rapidly. The advance of anaemia is 
also steadily progressive. 

Dropsical e£Fusion is not uncommon. It is often prominent in 
the horse as stocked limbs, but may be absent for a length of 
time. In other animals it is more likely to appear later in the 
disease and under the chest or abdomen or in one of the internal 
serous cavities. Trasbot has found it absent for months in the 
nephritic dog. 

The exploration of the kidney through the flaccid abdominal 
ivalls in small animals, and through the rectum in small horses 
and cattle, may reveal renal tenderness and even swelling. If 
there is a tendency to frequent passage of urine in small quanti- 
ties, or to straining without micturition, the indication is of 
value. 

There may be little or no fever, and, when left at rest, little 
•evidence of discomfort. 

Any indication of urinary trouble, and especially with dropsy, 
weakness, flabbiness and anaemia and a .subnormal temperature, 
should lead to examination of the urine, as a crucial test. A 
high density is good ground for suspicion. But this is not con- 
stant. In advanced cases (chronic interstitial nephritis, small 
white kidney, atrophic nephritis) it may be 1015 to 1025, in ex- 
ceptional advanced cases with polyuria, it may be loio, 1005, or 
•even looi. With such a condition, however, there is great 
anaemia, pallor of the muscoae, and prostration. Tested with 
nitric acid and heat, the urine throws down an abundant precipi- 
tate of albumen. Under the microscope it shows a profusion of 
granular, degenerating epithelial cells, and casts of the urinifer- 
ous tubes. 

Progress. The course of the disease is usually slow, extending 
over several months, but with a tendency to constant advance. 
The thirst increases and the urine increases in an^ount, clearness 
and levity. There may supervene extreme sluggishness, drop- 



240 Veterinary Medicine. 

sies, anaemia, and weakness, irritability of the heart, and pal- 
pitations on slight exertion. So long as the heart's action is 
strong, elimination may be maintained and life prolonged for 
months (in cow, Dickinson), oryears(FriedbergerandFr6hner). 
When the heart's action becomes weak, elimination is rendered 
imperfect and the animal shows catarrh of the lungs or bowels 
(common in dogs), local inflammation of the lungs, pleura or 
pericardium, or cedemas, or haemorrhages. The toxic eflFect on 
the nerve centres is shown by stupor or lethargy, or vertigo. 
When an abscess forms it is associated with a temporary rise of 
temperature (Trasbot ). The patient may die in convulsions, in a 
state of coma, or by gradually advancing debility and failure of 
the heart. 

Lesions, In cases of comparatively short standing the kidney 
is usually of full size, or somewhat enlarged, with firmly ad- 
herent capsule and rough or even nodular surface. The surface 
of the cortex may be red or grayish or parti-colored, pink and 
gray. The cortical portion is firm and it may even be attenuated 
somewhat, while the medullary portion, naturally lighter, has 
often grayish streaks converging toward the hilus. When the 
gray streaks are scraped with the knife a serous fluid, mixed with, 
fatty granules or globules, is obtained. The glomeruli may be 
still about the normal size with some increase of the epithelial 
tuft cells. The tubules contain casts (colloid, hyaline, granular), 
and their epithelium normally columnar, are flattened down to- 
cubes and are swollen, granular or fatty. 

In cases of older standing the connective tissue has usually 
undergone a marked increase. The capsule is thick, dense and 
adherent. The cortical substance is shrunken with a great in- 
crease of the fibrous elements, and the same holds true of the 
medullary portion. In consequence of this, even in the cortical 
substance the white or gray color predominates. The parenchy- 
matous tissue (glomeruli, tubules) have greatly shrunken. In 
connection with the contraction of the forming fibrous hyper- 
plasia, there is a general shrinkage of the kidney in size, it may 
be to one-half its original volume. Trasbot reports a case of 
nephritis, of 8 months standing, in the dog, with a kidney half the 
normal size, in the end the parenchyma may have practically 
disappeared, and the kidney may have shrunken to a small, firm,. 



Chronic Nephritis, 241 

white, fibrous mass. Abscess of the kidney is exceptionally met 
with (Laurent, Lafosse). 

Lesiofis of distant organs are not uncommon. Bronchitis, 
pneumonia, pleurisy, insufficiency of the tricuspid or mitral 
valves, dilated heart, hypertrophied or fatty heart, congested or 
fibroid liver, arteritis, and dropsies are among such morbid con- 
ditions. 

Prognosis, This is almost always unfavorable. Death may be 
delayed for months or years, and partial transient recoveries may 
take place but a restoration to normal structure and function is 
not to be looked for. 

Treatment. This cannot be expected to be much more than 
palliative. The avoidance of overwork, and of the exposure to 
cold and wet, and the securing of a free action of the skin by 
warm buildings and clothing, are essential. The diet should be 
easily digested and non-stimulating, for herbivora gp-een food, car- 
rots, roots, apples, silage, with a moderate allowance of oats to 
counteract weakness and anaemia ; and for camivora, milk, butter- 
milk, mush made of oat, wheat or barley meal, with, if necessary, 
a slight allowance of tender raw meat. Tonics fill a similar need. 
Iron and bitters may be combined. Or hydrochloric acid or nitro- 
muriatic acid with bitters (nux, calumba, salicin, quassia) may 
be tried. These acids are especially valuable. when the case has 
originated in or is maintained by calculi, indigestion or hepatic 
disorder. When the heart is defective in tone, it may be stimu- 
lated by small doses of digitalis, strophanthus, spartein, cafFein, 
or nitro-glycerine, or to a certain extent by strychnia or nux. 
These, however, must be used with judgment, if it is found that 
they aggravate the case by increasing the arterial tension. In 
those cases in which there is an excessive secretion of watery 
urine, the possible source of this in musty aliment should be 
avoided, and the flow checked by nux vomica, in moderate doses, 
and bromide or iodide of potassium in full doses. When, on the 
other hand, the urine becomes scanty and dense, the gp^eat danger 
of a toxic action must be met by agents that favor excretion. 
Pure water at will is perhaps the least objectionable of such 
agents, but potassium or sodium acetate or citrate, or even sodium 
chloride, in weak solution, may be given. In some cases benefit 
will come from a moderate use of the balsam of copiaba, or the 
16 



242 Veterinary Medicine, 

leaves of buchu, or piperazine. which may improve the tone of the 
secretory elements. The most promptly effective of these agents is 
pilocarpin (FriedbergerandFrohner), but it has the serious draw- 
back of inducing profuse and dangerous depletion and debility. 
Yet in careful hands, and with good cardiac tone, it may often be 
used to advantage. 

Fomentations over the loins, warm baths and mustard embro- 
cations, may at times be beneficial. Attempts have been made to 
check the hyperplasia by the use of arsenic, mercury or the com- 
pounds of iodine, but their use in such cases is based on theory 
rather than accomplished results. 



HYPERTROPHY OF THE KIDNEY. 

Hypertrophy of both kidneys has not been recorded in do- 
mestic animals. On the other hand the extraordinary develop- 
ment of one in compensation for the loss or atrophy of the other 
is not uncommon. In this the organ follows the general law of 
adaptation, seen in the double symetrical organs (testicle, etc.) 
and the more so that its functional activity is indispensable to life. 
Among causes are : blocking of an ureter by calculus, worms, 
neoplasm, nephritic abscess, gangrene, etc. The enlargement 
of the remaining kidney is a vicarious act and essentially a 
physiological one. 

If compensation is perfect, it may be impossible to detect symp- 
toms apart from those of the primary disease. 

Prognosis, Life is endangered in case of any subsequent kid- 
ney disease. 



ATROPHY OF THE KIDNEY. 

Result of hyperplasia of connective tissues and compression and absorp- 
tion of parenchyma. Unilateral or partial. Causes : chronic productive in- 
flammation, calculus in tubes, ureter, or pelvis, tumor, retention C3rst, em- 
bolism. Lesions : sclerosis of kidney, firmness, pallor, anemia, lack of 
glomeruli and tubules, cysts, congenital, urinous retention, colloid. Symp- 
toms : reduced secretion, palpation of kidney. Treatment : Prevention : 
arrest conditions, abundance of water, succulent food, parasiticides, opera- 
tion on cysts, counteract nephritis. 

Unlike hypertrophy, this is constantly the result of a patho- 
logical process. So long as a normal functional activity of the 
secreting elements is carried on, such parts must maintain their 
size and healthy characters. But with the compression of such 
secreting elements (glomeruli and convoluted tubes) by a hyper- 
plasia of connective tissue, by pressure from without or from the 
damming back of the urine in the pelvis and tubes, the secretory 
elements are absorbed and removed, and the final result is a 
general atrophy. If such atrophy appears in both kidneys at 
once it can only be very partial in extent, as extreme atrophy of 
both, with loss of their secretory function, would entail poisoning 
and death from the retained urinary products. The comparative 
frequency of the disease may be inferred from the reports of the 
numbers of specimens found by Barrier and Moussu in old horses 
in the dissecting rooms. The latter observed a dozen cases in a 
single winter, other examples are recorded by Cadeac (horse), 
Soula (swine) and Trasbot (in various animals). 

Causes, The most common source of the condition is the 
occurrence of chronic productive inflammation. The new 
product in such cases, if not pus, or a growth that rapidly passes 
into fatty or granular degeneration, or into gangrene, tends to 
form tissue of a low organization, especially fibrous. The re- 
sulting increase of the fibrous trabeculae, in undergoing subse- 
quent contraction necessarilyjcompresses the secretory tissue and 
the final result is a visible and, it may be, extreme wasting. 
Hence any slowly advancing productive inflammation is liable 
to result in absorption and removal of the kidney parenchyma, 
and distinct atrophy of the gland. 
243 



244 Veterinary Medicine, 

Again the obstruction of the ureter by a calculus in the 
pelvis which falls into the infundibuliform entrance, or a stone 
•arrested at any part of the duct (or even of the urethra) or by 
worms, hydatids, cysts or tumors, throws back on the kidney 
the secreted urine, which distending the pelvis and urinifer- 
ous tubes leads to direct compression and absorption of the 
secretory parenchyma. Direct compression of the kidney by 
an adjacent tumor will act in a similar manner. Retention cysts 
by their gradual increase and augmenting pressure cause ab- 
sorption of the gland tissue. 

The blocking of individual uriniferous tubules by minute 
calculi, which is so often seen in cattle, kept on dry feeding 
in winter, is a cause of partial nephritis, and absorption, as 
noted by Roll. 

A somewhat rare cause of atrophy is the diminution of the 
blood supply by arteritis and embolism of the renal artery, or 
by pressure of tumors on that vessel. Arteritis and blocking 
suggests at once the possible agency of the strongylus (sclero- 
stoma) armatus in the horse. Trasbot records a striking instance 
of compression of the renal artery and kidney by an enormous 
sublumbar melanoma. This occurred in an aged horse and 
led to atrophy. 

Lesions, In cases due to productive inflammation with sclerosis 
of the kidney, the firmness, pallor and bloodlessness of the 
organ is a marked feature. When incised it is found to be 
composed mainly of fibrous tissue, while the glomeruli and 
tubuli have to a large extent disappeared. 

If there has been simple lack of circulation the kidney becomes 
flaccid, pale and small in size. The secretory elements (glomer- 
uli and uriniferous tubes) are first absorbed, leaving the fibrous 
network, which tends to shrink and form a hard resistant mass. 
In extreme cases there may be absolutely no glandular tissue left, 
and the dense shrunken mass represents only the hyperplasia of 
the original fibrous network. In the different successive stages 
of this process the glomeruli and tubules become flattened, the 
epithelial cells become granular, or contain colloid casts and re- 
frangent elements like oil globules and finally they are repre- 
sented by a small mass of fibrous material. 

Of all the atrophies caused by the pressure of tumors perhaps 



Atrophy of the Kidney. 245 

that caused by cysts is the most characteristic. There may be a 
single cyst or they may be multiple ; they may range in size from 
a pea to the size of the two fists the total size exceeding that of 
the normal kidney. In all such cases the cysts project visibly 
from the surface of the organ. They vary according to their 
origin and nature. Congenital cysts are said to have resulted 
from distention by retained urine of the capsule of the glomerulus. 
The arterial tuft is atrophied and flattened against the wall. 
Serous cysts with clear contents are found in the old. Urinous 
cysts again form by dii^tension of the tubules that are obstructed 
by cysts or minute calculi. Colloid cysts are found in certain 
forms of nephritis formed by the dilatation of the capsule of the 
glomerulus or of the uriniferous tubules. The liquid often con- 
tains leucin, tyrosin and cholesterine. In all such cases the walls 
of the cyst become thick, and the glandular parenchyma is com- 
pressed leading to progressive degeneration and atrophy. 

Symptoms of atrophy of the kidney are necessarily those of 
suppression of urine, with, in certain cases, the passage of casts of 
the uriniferous tubes and of crystals of salts. There are, how- 
ever, no absolutely pathognomonic symptoms. When the kidney 
can be reached through the flaccid walls of a comparatively empty 
abdomen, or through the rectum, its hard, shrunken condition 
may assist in diagnosis. 

Treatment is not successful in advanced cases. Prevention is 
to be sought by obviating or treating the conditions on which the 
atrophy depends. Nephritis must be treated on general principles. 
Calculi must be avoided by a liberal supply of water, by soiling, 
or by pasturage. Strongylus parasitism should be dealt with by 
destroying the parent worms in the bowels, and by securing pure 
drinking water free from their eggs and embryos. Cysts, and 
tumors are only amenable to surgical measures and not often 
open even to these. 



FATTY DEGENERATION OF THE KIDNEY : STEATO- 
SIS OF THE KIDNEY. 

Causes : age. overfeeding, idleness, atony, retention of urine. Lesions : 
kidney enlarged, pale yellow, capsule loose, cat surface glistening uuctuous, 
oil globules in scrapings, granules soluble in ether. Symptoms : in idle, 
overfed, obese, imptoved meat producing breeds, closely confined, starchy 
or saccharine food, fatty granules in urine, finally, dropsies,an8emia, debility, 
sluggishness. Prognosis unfavorable in advanced stages. Treatment : 
butcher, restricted regimen, open air exercise, nitrogenous diet, crossing, 
diuretic food or drugs, oil of turpentine, balsam copiaba. Palliation only. 

Fatty degeneration of the kidneys is by no means unknown in 
the domestic animals. It has been observed in dogs and cats 
(Rogers, Goubaux, Vulpain, Trasbot). In dogs it has been 
erroneously set down as a characteristic lesion of rabies. Like 
fatty degeneration of other organs, it is also met with in old 
and over-fed individuals of meat producing breeds of animals, in 
which the tendency to early maturity and rapid and excessive 
fattening has been fostered from generation to generation. In 
man small, granular, fatty kidney is a common result of chronic 
parenchymatous nephritis, and often coincides with fatty liver. 
Chronic poisoning by arsenic or phosphorus is another cause, as 
it is of fatty degeneration in other organs. 

Vulpain has attributed it to a lack of active exertion and of 
general tone, associated with excessive amylaceous feeding, 
sluggish, shallow breathing and tardy elimination. Goubaux 
and Trasbot attach great importance to the compulsory retention 
of urine in house dogs, cats and horses. The damming back 
of the urine in the convoluted tubes and glomeruli, temporarily 
arrests secretion, and the inactive and compressed cells tend 
at once to granular and fatty degeneration. 

Lesions, The gland is sensibly increased in size, and pale 
yellowish or straw yellow. The capsule is easily detached from 
the cortical substance, contrary to what is the case in chronic pro- 
ductive inflammation. The cortical substance is increased in 
thickness, and pale, the pallor being largely in ratio with the du- 
ration or extent of the fatty degeneration. The cut surface may 
be glistening and unctuous to the touch. It is softer than usual, 
246 



Fatty Degeneration of the Kidney, 247 

rather friable, and if scraped, furnishes a serous or grayish pulp 
in which oil globules are prominent features, together with gran- 
ular epithelium and free granules that dissolve readily in ether. 
Tubules are varicose and unequal at different parts. The medul- 
lary portion has undergone little change. It may be paler at cer- 
tain points, with some shrinking of its substance and increase of 
firmness. 

Symptoms, As a rule the disease occurs in pampered, overfed 
and obese animals, and in those of the improved breeds which 
have great power of digestion, assimilation and fattening. It is 
especially to be looked for after close confinement on full, stimu- 
lating, amylaceous diet. Symptoms are not usually recognized 
during life. There is, however, a lessening of the urinary secre- 
tion, and, as the disease advances, albuminuria. When ex- 
amined microscopically this is found to contain characteristic ele- 
ments, such as granular epithelial cells, the granules soluble in 
ether, oil globules, and at times crystals of cholesterine (Beale). 
A diagnosis based on the mere presence of oil globules may, how- 
ever, be fallacious, as these may be present in animals that have 
just been heavily fed on oleaginous food, and again the oil used 
to smear the catheter may float in the urine and prove misleading. 
Under such circumstances vaseline or glycerine may be substi- 
tuted on the catheter. Scriba induced fatty urine by injecting 
fat or oil emulsion into the blood, and Chabrie by ligating the 
large intestine. Trasbot says that cylindroid casts may be 
present. As in other grave kidney affections, dropsies supervene 
as the disease advances. These may show in the limbs, in the 
abdomen, or in other serous cavities. A steadily advancing 
anaemia with pallor of the mucosae, listlessness, weakness, debility 
and sluggishness are to be noted. 

Prognosis, Since the disease is rarely diagnosed until it has 
reached an advanced stage, it usqally progresses steadily to a fatal 
issue. If, however, it can be detected at an earlier stage, it may 
be palliated, or held in abeyance, for a length of time varying 
with the extent of the lesions. As it is very largely a disease of 
meat producing animals and as the subject is at first in a condition 
of marked obesity, it can usually be turned over to the butcher 
without material loss. 

Treatment, If the disease has resulted from the inbred pro- 



248 Veterinary Medicine, 

pensity to fattening, the family that shows the disposition must 
be subjected to a somewhat different regimen, open air exercise 
must take the place of confinement in warm stables, a rather bare 
pasturage is valuable for herbivora, and restricted diet in which 
the oleaginous, saccharine, and amylaceous constituents do not 
predominate, is strongly indicated. Crossing with a strange male 
having many of the desirable qualities of the herd, but which is 
more vigorous may be resorted to. When the secretion of urine 
becomes scanty an abundance of pure water, or a diet of succu- 
lent grass or roots or ensilage or even small doses of alkaline 
diuretics may be resorted to. Any source of arsenic or phosphorus 
poisoning should be cut off, and as an antidote to phosphorus, 
oil of turpentine may be given in small doses. This agent may, 
indeed, replace the alkalies as a diuretic, bringing in an element 
of tone for the mucosa which is not to be despised. Or balsam of 
copiaba or buchu leaves may be substituted. 

When the small white kidney (granular, fatty) results from 
chronic nephritis, the prevention and treatment would be as for 
that disease. Little hope is to be entertained of entire restoration 
to health. 



AMYLOID KIDNEY. LARDACEOUS OR WAXY KIDNEY. 

This condition of the kidney has been found in the ox (Ger- 
lach) and dog (Rabe, etc. ) . There are commonly similar degenera- 
tive lesions in the liver, pancreas, intestines and other organs. It is 
usually a concomitant of some chronic wasting disease (chronic 
nephritis, tuberculosis, etc.). 

Morbid Anatomy. The kidney is usually enlarged, pale and on 
section waxy or glistening. Soaked in dilute compound tincture 
of iodine it shows spots of a walnut or mahogany brown color. 
The glomeruli are well marked and show the earlier changes, 
later the tubes do so excepting the epithelium. The latter is 
swollen, granular, fatty. 

Symptoms. There may have been those of chronic nephritis. 
Rabe has noticed in dogs dropsy of the limbs, ascites, emaciation, 
anorexia, followed by uraemia, coma, weakness, vomiting, and if 
the kidney alone was affected great lowering of temperature 



Renal Calculus, 249 

(35-9^ C). With hepatic complication there was greater weak- 
ness, giddiness, and higher temperature ( 39. 6® C ) . Urine is com- 
monly increased (in man albuminous) and the casts have shown 
the amyloid reaction. They tend to be fatty or finely granular. 
Casts may, however, show amyloid reaction when the kidney, 
post-mortem, does not (Jaksch). 

Diagnosis from Bright's disease is often impossible. 

Treatment is essentially the same as in chronic nephritis, and is 
not hopeful. 

Trasbot recommends KI 3 to 7 grs. , or tinct of iodine 3 drops 
for shepherd dog. Ol. terebinth and alkaline diuretics are also 
commended. 



RENAL CALCULUS. 

This is much more common than is supposed. Small calculi 
formed in the tubuli uriniferi of cattle on dry winter feeding often 
pass without recognition, and habitually disappear on rich spring 
and summer grass. 

If retained in the pelvis until increasing size forbids their pas- 
sage through the ureter they form pelvic calculi. 

If retained in the bladder so that they cannot enter the urethra 
they form cystic calculi. 

Pelvic calculi or concretions are often (in cattle and swine) mere 
scales l3dng in chalices. They may fill the whole pelvis and send 
branching processes into chalices. 

Causes, They are attributed to phosphaturia, lithaemia or uric 
acid diathesis, oxaluria, etc. In cattle they are associated with dry 
feeding and are common on all magnesian limestone soils. There 
are usually catarrh of the kidney and the presence of bacterial fer- 
ments and colloids (pus, albumen, etc.). (Sharing and Ord.) 
Calculi or gravel is preceded by renal catarrh, but this is aggra- 
vated by the crystalline deposit. Bacteria act also in producing 
NH,0, which instantly precipitates ammonio-magnesian phos- 
phate. Retention of urine greatly favors the precipitation. 

Symptoms, A white or brownish yellow deposit in the last urine 
discharged collects on the floor. Cloudy urine. Passage of crys- 
tals — round— or angular. Colic. Lameness in one or both hind 



250 Veterinary Medicine. 

limbs. Arched back. Sensitive loins. Pain paroxysmal. Attempts 
to urinate. Little passed but often with drops of blood. Sudden 
relief when the calculus enters the bladder. 

Retained in the kidney it may cause no suffering in meat pro- 
ducing animals, but in horses it usually causes stiffness or lame- 
ness especially under violent effort. Also hematuria ; blood glob- 
ules are found in the deposit when placed under the microscope. 
There may be sepsis and specially cloudy offensive urine. 

Diagnosis : May be confounded with renal tuberculosis, or sar- 
coma or oxaluria. Examine for bacillus, small cells, or oxalate of 
lime or oxalic acid. 

Prophylaxis, In the early stages give succulent, watery food, 
ensilage, roots, potatoes, spring grass, and water ad libitum. 

Treatment, Salt may tempt the patient to drink. Nitro-muri- 
atic acid is a solvent and antiseptic. Or alkalies with salicylate 
of soda. Also tonics. Quiet pain by morphia and other anodynes. 
Use piperazine. 

These failing, an operation on the kidney may be considered. 

HYDRO-NEPHROSIS. 

A common result of calculus or other obstruction, causing in- 
creasing pressure of urine in the pelvis and absorption of the 
parenchyma, and finally leaving a mere urinous sac. 

RENAL TUMORS. 

1. Non-malignant: Fibroma. 

Lipoma. 
Angioma. 
Adenoma. 
Papilloma. 

2. Malignant : Sarcoma. 

Carcinoma. 

RENAL PARASITES. 

Echinococcus : Herbivora, Omnivora. 
Bilharzia Crassa : Egyptian cattle. 
Strongylus Gigas : Horse, ox, dog, man. 
(Cysticercus TenuicoUis : Ruminants: Pig). 
Taenia serrata : Dog. Pelvis. 



Injuries of the Ureters, 251 

Sclerostoma equinum : (renal arteries, ^'^ifw^/^/m), soliped. 

Stepbanurus dentatus : Pig, (pus cavities). 

Trichosoma plicata : (Urinary bladder), dog. 

T. felis : (Cat), bladder. 

Indetermined embryos : Kidney, dog ; small tumors. 

Cytodites nudus : Kidneys ; bens. 

CBstrus, (Gast. Hemorrhoidalis) : Bladder walls ; borse. 

Mucorimyces : Kidneys ; dog. 

Coccidia : Kidney, Horse, dog. goose. 



INJURIES OF THE URETERS. 

Lesious by bullets, arrows, stabs, bruises and lacerations in parturition, 
treads, wheels, tumors, ulcers, calculi, tubercles, parasites. Course. 
Pathology : transverse division may cause hydronephrosis, or septic peri- 
tonitis. Symptoms : uncertain, traumatism, bloody urine, arched, stiffs 
tender loins, straining, recumbency, groaning in turning or rising, rectal 
palpation of distended ureter, of ascitic fluid, pitting on pressure of loin, 
flank or f^roin, liquid drawn through a cannula is urinous, urine still dis- 
charged by normal channel. Crystals in urine, worm ova. Treatment : 
compresses, fomentations, sinapisms, anodynes, balsams, antispasmodics, 
extraction of calculus, lateral implantation of urethra. 

From tbeir deep and protected position it might be plausibly 
concluded tbat tbe ureters were secure against every kind of 
traumatism. This however, is not tbe case, since in botb man 
and animals tbey bave been known to bave been injured by 
bullet wounds, arrow wounds, and stab wounds of various kinds. 
In distokia with laceration of tbe womb, vagina or bladder tbe 
ureter is liable to be injured. By blows and kicks it may even 
be ruptured or torn across, and also by sudden and severe me- 
chanical compression of tbe abdomen as when run over by a 
wagon or trodden on by a borse, ox, or other large animal. Tu- 
mors of various kinds may grow in, or press upon the ureter, 
ulcers with thick indurated margins or base may obstruct the 
passage, or calculi, or worms may block and give rise to over- 
distension and even rupture. Kopp describes obstruction by 
multiple calculi with saccular dilation in front, close to the kidney 
in a cow. Cadiot records cases of thickening of the mucosa by 



252 Veterinary Medicine, 

numerous cysts as small as bempseed . Intra-abdominal tumors of 
tbe spermatic cord bave been known to block tbe passage. Again 
tubercles bave formed on tbe uretbra, and polypi on tbe trig- 
onum vesicae bave blocked tbe ureter and produced all tbe evil 
consequences of calculus, parasites, etc. 

Course, . Tbe progress of tbe disease will vary greatly according 
to tbe nature of tbe lesion. Witb complete rupture of tbe ureter 
tbe urine as a rule escapes into tbe peritoneal cavity. If tbe 
urine is aseptic tbis may not lead to serious results and tbe edges 
of tbe wound cicatrizing, tbe urine is imprisoned in tbe tfreter 
and pelvis of tbe kidney, and leads to final atropby of tbe kidney 
and bydro-nepbrosis. Wben on tbe otber band infecting matter 
escapes witb tbe urine, as in perforating ulcer, tubercle, glanders, 
cancer, infective catarrb of tbe kidneys or ureter, sucb infection 
is brougbt in contact witb tbe wbole peritoneal surface, wbere 
secondary infections follow. In cases associated witb penetrating 
wounds, wounds resulting from dystokia, calculous or parasitic 
obstruction, similar infection is to be dreaded. 

Tbe symptoms are by no means clear, unless tbe injury result 
from external traumatism, or wben it can be detected by rectal 
exploration. Tbere may be blood staining of tbe urine, stifiFness 
of tbe loins, lameness in one bind limb, tenderness of tbe lumbar 
vertebrae and of tbeir tranverse processes on pincbing. frequent 
straining to pass urine, a disposition to remain recumbent, pain 
and groaning wben rising, or wben turned in a narrow circle. 
Under rectal examination tbe blocked ureter may sometimes be 
recognized, its cystic end sbrunken and empty, up to tbe seat of 
obstruction, and its renal end, from tbe bypersensitive seat of ob- 
struction forward, full, rounded, elastic and firm. If tbe ureter bas 
been ruptured, it may be impossible to distinguisb it, but tbe 
presence of urine free in tbe peritoneum may be detected tbrougb 
tbe rectum as it may often be tbrougb tbe abdominal walls. 
Sometimes tbe urine infiltrates tbe subperitoneal connective tissue, 
and forms a pasty swelling on tbe loin or flank. In eitber case a 
bollow needle inserted will draw off a liquid baving an urinous 
odor. Tbat tbis urine bas escaped in front of tbe bladder may be 
safely inferred from tbe continued discbarge of urine by tbe 
uretbra and by tbe absence of cystic swelling, beat and tender- 
ness. If tbe kidney can be reacbed by rectal exploration it is 



Injuries of the Ureters. 253 

felt to be firm and resistant up to the period of rupture of the 
ureter. 

In case of obstruction by calculus, crystals and even small cal- 
culi may be passed in the urine, there is usually a history of 
previous attacks of renal colic, and the suffering is manifestly ex- 
treme. In case of worms (strongyjius gigas) the use of the cen- 
trifuge on the urine, may possibly secure in the sediment speci- 
mens of its ova. The existence of tumors or tubercles can usually 
be clearly made out. 

Treatment will be as varied as the lesion. Simple ureteritis 
may be met by wet compresses, sinapisms, and internally by bal- 
sams and anodynes. Calculi and parasites may be passed with 
some aid perhaps from fomentations, antispasmodics, and diluents. 
Obstinate cases can only be successfully met by surgical interfer- 
ence. . The resulting wounds in the ureter, like ruptures, perfor- 
ating ulcers and strictures may be met by Van Hook's ''lateral 
implantation ' ' / the divided cystic end of the ureter is ligatured 
and on the cystic side of the ligature a longitudinal incision is 
made, large enough to admit the divided extremity of the renal 
portion, and through each of the two sides of this last a fine liga- 
ture is passed ; these ligatures are then passed into the lumen of 
the cystic portion of the ureter through its longitudinal incision 
and brought outward through its walls ; next the renal end is in- 
serted into the incision in the cystic end and the two are firmly 
sewed together by the two ligatures. , When a small portion of an 
ureter must be excised it may sometimes be possible to save a val- ' 
uable animal by such an expedient. 

In some cases of rupture into the vagina or uterus an available 
fistula may sometimes be established into one of these. 



URETERITIS. 

Prom wounds, calculus, parasites, infection, injuries in parturition. 
Symptoms : in wounds of ureter. Course : danger of infection of kidney or 
bladder. Treatment : for calculus, antispasmodics, anodynes, fomentations ; 
for pardsites, arsenious acid ; for catarrhal conditions, balsams, buchu, 
salicylates, etc. Operation. Uretero-vaginal fistula. 

This may arise from the passage of a rough calculus, from 
wounds of the ureter sustained in kicks and blows or by being run 
over by wheels (dogs, cats), it may be due to the blocking of the 
tube by a parasite such as strongylus gigas, ecchinococcus, etc., or 
it may be the result of extension of an infectious inflammation 
backward from the kidney or forward from the bladder. Again 
it may be the result of a lesion of the ureter in cases of dystokia. 

The symptoms are obscure but there is likely to be frequent 
straining and passage of urine, tenderness of the loins, all the 
more significant if confined to one side, lameness or halting on 
the corresponding hind limb, and on examination through the 
rectum the swollen and tender cord representing the ureter may 
be recognizable. In case of calculus or other obstruction the 
ureter may be felt to be swollen, elastic and tender back to a 
slight nodular, painful, firm swelling at the seat of obstruction. 

Course, In all such cases there is always danger of inflamma- 
tion (infectious or otherwise) of the kidney with degeneration 
and loss of structure and function, the organ being reduced to a 
simple urinous cyst (hydronephrosis). In some cases, however, 
the obstruction (calculus, parasite) may escape into the bladder 
and a recovery follow. Slight infections, too, may improve and 
advance to complete convalescence. 

Treatment will depend much on the causative factor : Calculus 
must be treated by anodyne anti-spasmodics, and fomentations, 
and in case of relief by measures calculated to prevent its forma- 
tion anew : parasites may be treated by arsenious acid , oil of turpen- 
tine, and other parasiticides which are secreted by the kidneys : 
catarrhal and infected conditions may be met by balsams, buchu, 
salicylic acid, piperazine, and even peppers. In case of calculus 
which does not give promise of passing, even a surgical opera- 
tion may be thought of, especially in the smaller house animals. 
254 



Acute Catarrhal Cystitis, 255 

In rupture of the ureter in dystokia the walls of the womb or 
vagina have usually suflFered, and a recovery with a uretero- 
aterine or uretero-vaginal fistula is not unknown. 



ACUTE CATARRHAL CYSTITIS. 

Acrid diuretics, by month or skin, microbian inrection, retention of urine, 
urethral calculus, parasites, spasm, enforced suspension of micturition, un- 
•clean catheter, adjacent infection, chill. Lesions : hypersemia of mucosa, 
thickening, vascular distention, clouding of epithelium, muco-purulent se- 
-cretion, alkaline fermentation, ammonia liquefaction of cells, erosion. 
Symptoms : Slight fever, stiff, straddling gait, urine scanty, cloudy, alka- 
line, penis or clitoris semi-erect, smearing of tail or prepuce. Crystals of 
triple phosphate. Treatment : Antiseptics, boric or salicylic acid, gum 
arable, astringent, antiseptics, laxatives, flax seed, slippery elm, anodynes, 
diluents, piperazine, drainage rest, restricted laxative diet, warmth, avoid 
stimulants. 

Causes. Cystitis is caused in all animals by irritant diuretics 
like cantharides, copaiba, or oil of turpentine given by the mouth 
or applied to an extensive cutaneous surface. It is an error, how- 
ever, to conclude with Williams that this is the sole cause. The 
very existence of calculi virtually implies bacterial infection, and 
fermentation. The presence of free ammonia in the urine usually 
implies fermentation, and fermentation must be looked upon as 
practically synonymous with microbian invasion. That bacteria 
may be present without serious injury is undoubted. The pro- 
tective power of the healthy mucosa is very great. But when the 
mucosa iy weakened, microbes that would otherwise be harmless, 
find a ready infection-atrium, and triumph over the weakened 
tissues. Hence retention of urine and overdistension of the blad- 
der as in urethral calculus, blocking of the urethra by a parasite, 
spasm of the sphincter vesicae, compulsory retention as in the 
mare in harness, the dog kept indoors, or in railway car on a 
long journey, or in mares so travelling, may become the occasion 
of cystitis. Even in cases in which no microbe is present at first, 
this reaches the bladder by the introduction of an unclean cathe- 
ter, or by extension from an uretheritis, vaginitis or metritis, or 
^even from a peritonitis, or infected urachus. Or the infection 



256 Veterinary Medicine. 

may descend from a suppurating kidney. Another occasion of 
microbian invasion is the congestion which attends on exposure 
to cold. 

Lesions. H3rperaemia of the cystic mucosa, with dilation and 
tortuous deviations of the larger vessels, thickening of the mem- 
brane, and distension and clouding of the epithelial cells, with a 
thick covering of tenacious mucus containing epithelial, pus, or 
white blood cells. As the disease advances epithelium is desqua- 
mated abundantly, and degenerates with production of free nuclei 
and pus. Along with these are microbes, usually the bacillus coli 
communis, and various cocci. In the fully established disease 
there is liable to be alkaline fermentation, and the liberated am- 
monia dissolves the epithelial cells, leading to extensive desqua> 
mation and raw granulating surfaces, so that the malady tends to 
run in a vitiating circle, the alkali dissolving the epithelium and 
increasing the microbian development and fermentation, which in 
its turn produces an increasing quantity of ammonia. 

Symptoms. There is slight hyperthermia or none, stifiF or strad- 
dling gait, frequent passage of urine in small quantities and 
cloudy, or straining without passage, the penis or clitoris is semi- 
erect, eversion of the lips of the vulva is frequent, and the blad- 
der is tender (through prepubian wall, vagina or rectum). If a 
finger is inserted into the bladder in the mare the thickening of 
the walls can often be recognized. The urine often contains pre- 
cipitated crystals of ammonio-magnesian phosphate, and even 
clots of blood. It has an alkaline reaction even in herbivora. 

Treatment. The danger centres around the bacteridian fermen- 
tations, and a main object must be to disinfect the bladder. This 
will be all the more effectual if the lotions used are of an acid re- 
action. Thus boric acid or salicylic acid in 3 per cent, solution, 
injected after evacuation of the bladder and repeated a number of 
times a day may soon establish a healthy action. If the bladder 
is especially irritable a boiled weak solution of gum arabic will 
form a suitable medium. Other antiseptics are often used as 
creosote (0.5 : 100), carbolic acid (3 : 100), chloride of zinc 
(3 : 100), chlorate of potash (3 : 100), mercuric chloride ( i : 5000), 
silver nitrate (0.5 : 100), or astringents are often better : PbA, 
Zn S O4 tannic acid, ferri chloridi in dilute solution so as not to 
cause pain. 



Acute Croupous Cystitis, 257 

The bowels should be kept open by an occasional saline laxa- 
tive, pain moderated by codeine, and abundance of pure water 
and a laxative diet enjoined. Linseed tea, and infusions of slip- 
pery elm or marsh mallow have long been employed, and by 
soothing and relaxing the bowels they act favorably on the 
urinary mucosa. Stimulants of the urinary track like buchu, 
uva ursi or copaiba in small doses, or antiseptics like creosote, 
boric acid, salicylic acid, peperazine, are available in slight cases or 
when the acute symptoms have subsided somewhat. With prior 
infection of the kidneys, the latter may be used. Constant drain- 
age may be necessary to avoid distension. 

Perfect rest is absolutely essential, a restricted laxative diet, 
and a careful avoidance of cold, and stimulants. 

When urine is retained it should be removed with a thoroughly 
asceptic catheter. 

In case of blood clots in the bladder, wash out with a boiled 
normal salt solution. 



ACUTE CROUPOUS CYSTITIS. 

This has been found to follow the use of cantharides and other 
irritant diuretics, and to follow on certain specific diseases. Its 
nature is that of catarrhal inflammation, but with a fibrinous 
product or false membrane formed more or less extensively on the 
inflamed mucosa. 

Symptoms are essentially those of catarrhal cystitis from which 
it is distinguished by the presence in the urine of flakes of the 
fibrinous membrane. 

Treatment is essentially the same as in the catarrhal form, to 
which may be added the injection of a solution of 4 grains scale 
pepsin to the ounce of sterilized water. The boric acid solution 
may be of the strength of 20 per cent. Irrigate two or three 
times a day. 
17 



CHRONIC CATARRHAL CYSTITIS. 

This may begin as a mild attack or it may continue after an 
acute one. It has been noticed in horse, ox, and dog. 

It may be associated with calculi, gravel, papilloma, and bac- 
terial invasion especially by the colon bacillus. 

Lesions. Mucosa and muscular coat are thickened, corru- 
gated, puckered and contracted so that the bladder will not con- 
tain more than a few ounces of urine. The surface of the mucosa 
is discolored, mottled and variegated, slaty blue, brown, red, 
purple, or even black, with ulcers, encrustations of triple phos- 
phate, and fungoid elevations. In dogs especially, the prostate 
is often enlarged. 

Symptoms, Frequent urination accomplished with pain, groan- 
ing, or whining and it may be with sudden arrest. There may 
be incontinence, the urine dribbling almost continuously from 
the penis or vulva and in the latter case trickling down the thighs. 
The presence of pus and mucus tends to mat the hairs, and a 
strong urinous and ammoniacal odor is emitted. 

Palpation of the prepubian region often, and of the vagina or 
rectum always causes pain and wincing. Temperature is normal. 

Urine is albuminous in ratio to the amount of pus, or above 
that, and is then suggestive of kidney disease and likely to be 
complicated by casts. 

Complicating lesions of the womb, vagina, prostate, and kid- 
ney are to be carefully looked for, also cystic papilloma. 

Prognosis, Recovery though not uncommon is too often but 
partial and it is usually desirable to fatten the animal. 

Treatment, Rest, moderate laxative diet, pure drinking water 
ad libitum, warmth, antiseptic irrigation. 



258 



CYSTITIS IN THE OX. 

Special Symptoms, Beside general disorder there is a dis- 
position to decubitus, but with frequent rising to urinate though 
the bladder is not filled to repletion. Then the urine is passed 
in a slow stream by abdominal contraction, and without pulsating 
contractions of the urethra at the ischium which are so marked 
in calculus. Cystitis is greatly aggravated by overdistension, 
and if the bladder is paralyzed is very liable to go on to rupture. 

Galtier considers enzootic haematuria as essentially a haemor- 
rhagic cystitis, due to marshy soils, disordered liver, often dis- 
tomatosis, and irritation of the urinary organs by the poisons 
which the liver was helpless to destroy or eliminate. 

The treatment of cystitis in cattle does not difiFer materially 
from that of the horse. 

The haemorrhagic form demands prevention by drainage, cul- 
tivation and the use of phosphates to the soil. 



CYSTITIS IN DOGS. 

The special symptoms in dogs are uneasiness and frequent 
changes of place. The patient passes urine often in small quan- 
tity, and with whines or cries. He walks slowly and stiffly with 
the back arched, and compression of the abdomen and especially 
of the prepubian region is painful to a marked degree. The tense 
elastic bladder may often be distinctly felt through the abdominal 
walls. The inflamed bladder is liable to paresis and paralysis 
with great overdistension, and aggravation of the general symp- 
toms, the eyes sunken, and dullness, stupor and coma betraying 
uraemic poisoning. Some claim rupture of the bladder as is so 
common in the ox. 

In the main, treatment is as for the horse. Rest, warm bath, 

or fomentations, catheterism with aseptic catheter, draw urine 

through hypodermic nozzle in prepubian region. Antiseptics : 

boric or salicylic acid by the mouth and bladder. Laxatives, and 

259 



26o Veterinary Medicine, 

plenty of water are important. Free access to open air where 
the animal can urinate, is very essential. In chronic cases, 
buchu, copaiba, balsams, or piperazine may be employed. Mus- 
tard blister. Electricity. Small doses of belladonna to give tone 
to the bladder. 



ATONY AND- PARALYSIS OF THE BLADDER. 

Causes, This comes usually from troubles of innervation. 
Paraplegia, dorsal and lumbar fractures with injury to the spinal 
cord, brain lesions, haemoglobinuria with effusion pressing on 
the cystic plexus, overdistension of the viscus, from cervical 
spasm, urethral stricture or calculus or parasite (strongylusgigas), 
acute or chronic cystitis. In dogs it may come from obstruction 
by enlarged prostate. Polypus blocking the cervix and chronic 
disease of the walls of the organ are additional causes. 

Symptoms, More or less complete retention of the urine. 
The bladder cannot be completely emptied except by powerful 
contractions of the abdominal muscles. Habitually it may es- 
cape in drops, or in jets at intervals during exercise. Palpation 
will show overdistended bladder as a tense, elastic mass. But as 
overdistension may occur without paralysis, no case can be cer- 
tainly diagnosed without catheterization to show that the urethra 
is free. 

When the paralysis affects the cervix, the urine escapes con- 
tinually and trickles down the insides of the hips in mares, or 
from the sheath in males. 

Diagnosis demands catheterism and rectal examination. 

Complication. Cystitis by retention. Infection by catheter. 

Treatment, Corresponds to causes. These corrected, use 
aseptic catheter often. After extreme distension empty partially, 
or inject a few ounces of borax or boric acid solution. Thus 
avoid collapse and inflammation, and secure antisepsis. Give 
tone by a course of strychnia, (ergot, belladonna), mustard 
blister ; turpentine in small doses. Better electricity, i pole in 
bladder, i on public symphysis. Apply for 5 minutes. 



TUMORS OF THE BLADDER. 

Recorded cases of sarcoma (Mauri), carcinoma (Cadeac, 
Hink, Friedberger), and tuberculosis can be adduced. Papilloma 
is perhaps as frequent as any of the above. The author has 
treated two cases of papilloma in mares complicated with multiple 
small calculi and gravel. Treatment is exclusively surgical and 
in the mare with the widely dilatable urethra this is sometimes 
possible through that channel. In the same animals diagnosis 
may be accomplished by introducing the finger into the urethra 
and bladder. In other females and males, vaginal or rectal pal- 
pation must be resorted to. 



VESICAL PARASITES. 

Eustrongylus gigas. Dog, horse, man. 
Trichosoma plicata. Dog. 
(Estrus Haemorrhoidalis. Mare. 



SPASM OF NECK OF BLADDER. 

Spasm of the cervix vesicae has been doubted, save as the re- 
sult of local inflammation, yet it not uncommonly takes place in 
horses and other animals in connection with irritation attendant 
on the retention of urine during work, or in dogs during a period 
passed indoors. Trouble and sufiFering continues, with ineffectual 
efforts to micturate, but practically complete relief is secured by 
catheterization or by a spontaneous abundant discharge. The 
neurosis which leads to it is produced or aggravated at times by 
enlarged prostate, or lesions in the urethra. Intense fear may 
cause it. 

Treatment, Remove cause. Give antispasmodics, valerian, 
musk, bromides, chloral hydrate, opium, stramonium, hyoscya- 
mus, codeine, etc. ; may be given as injections or suppositories. 
For the horse spread the litter and soothe by whistle or song. Or 
use the catheter and correct any local irritation. 
261 



RUPTURE AND LACERATION OF THE BLADDER. 

This occurs most commonly in oxen from obstruction of the 
urethra by a calculus. Similar obstruction in the horse causes 
most acute symptoms, calling for immediate relief, and rupture is a 
comparatively rare occurrence. Peuch mentions a case resulting 
from a fall during an attack of colic, and with a full bladder. It 
has happened during lithotrity, or lithotomy, and even during 
parturition. Perforation by parasites has been noted and in one 
case by an osseous tumor of the pubic symphysis. In horses a 
fatal result is prompt, in cattle from 6 to 48 days. 

Treatment surgical. 



EVERSION OF THE BLADDER. 

This is really invagination into the female urethra and vagina. 
It has only been seen in mares, and then by reason of the ex- 
treme dilatability of the urethra. A pyriform, red, perhaps ru- 
gose tumor shows between the lips of the vulva, during strain- 
ing. It is covered by mucosa, and on its upper surface near to 
its neck are two small orifices from which urine oozes or comes 
in jets during active expulsive efforts. It soon becomes muco- 
purulent on the surface, and even excoriated. Urine escaping 
continuously trickles down the thighs with much foetor. It 
occurs especially during violent expulsive eflForts as in parturition 
or constipation. 

Treatment essentially surgical consists in uniform compression 
to expel blood and exudate followed by the pushing of the 
fundus through the bladder and urethra. The more recent the 
case, the easier is the process. Pressecq claims to have cured an 
obstinately recurring case, by cauterizing the urethra up to the 
cervix vesicae with a round iron rod an inch in diameter. The 
resulting loss of substance, with the neoplasia and constriction 
effectually prevented renewed eversion even during parturition. 
Other veterinarians have successfully excised the bladder, but 
this entailed incontinence and constant offensive soaking of the 
thighs with urine. 
262 



HERNIA OF THE BLADDER. 

This is commonly seen in the mammalian female in connection 
with rupture of the floor of the vagina during dystokia. It has 
also been observed without such lesion in both male and female 
dogs and horses, the bladder forming a cystocele of the vagina, 
or bulging between the anus and the ischium. 

Diagnosis is confirmed by careful palpation through the 
rectum. The folding of the bladder backward obstructs the exit 
of urine. 

Treatment, essentially surgical, might include replacing of the 
organ and suturing of the wound, or, in the absence of a wound, 
evacuation of the bladder by a hypodermic needle, and replacing 
by palpation through the vagina or rectum. Sometimes suture 
of the vulva is desirable. 



ANOMALIES OF THE BLADDER. 

Persistent urachus. Seen in the new-bom and mainly in 
males. Antiseptic closure is essential after having ascertained 
that the urethra is pervious. 

Imperforate cervix vesicae. A case reported by Lapotre, in 
a calf, had no cervical orifice, and the ureters were blocked 
by pea-shaped nodules. 

Recto- vesical fistula. In a calf 13 days old the* rectum 
opened into the bladder and the faeces and urine escaped by a 
pervious urachus. (Kaufmann and Blanc). 



URETHRAL ANOMALIES. 

Imperf orations. In the new born male, foal, lamb, etc. Usually 

at the outer end, and it may be for some distance back. In one 

case the sheath was firmly adherent on the wall of the abdomen, 

thus shutting off all exit of urine. If the canal is absent only at 

263 



264 Veterinary Medicine. 

the orifice or for a short distance, the urethra beyond this can be 
felt full of liquid and fluctuating. The patient being properly 
fixed a fine trochar is pushed from the end of the penis into the 
blind end of the urethra, which will be ascertained by the over- 
coming of resistance. The trochar is now withdrawn aud the 
urine flows through the cannula. A catheter or sound is now tied 
in the passage to maintain it pervious until cicatrization shall 
have taken place. 

Hypospadias. Short urethra opening backward on the lower 
surface of the penis. Considered irremediable. 

Epispadias. Urethra opening on the upper surface of the penis. 
Much more rare. 



ACUTE URETHRITIS. CATARRH OF THE URETHRA. 

This occurs in all genera of domestic animals, and may be 
either acute or chronic. It is most common in the entire males, 
not only because of infections sustained in copulation, but be- 
cause frequent erection exposes the opening of the urethra to in- 
jury and inflammation, and to the entrance of pathogenic germs. 

Symptoms. Pruritus of the penis, and diflSculty and pain in 
urination and straining are frequent, but a single small jet may be 
all that is passed at a time. The papilla on the end of the 
penis is red and angry and somewhat swollen. Later a few 
drops of muco-purulent fluid may be pressed from the orifice. 
In the bull, dog and boar this oozes from the retracted penis into 
the sheath, so that a collection is found in that canal, and the 
mucosa becomes infected causing a balanitis. 

The infection may be conveyed from male to female and vice 
versa. Dr. Horand of Lyons even found that the muco-purulent 
discharge of gonorrhoea in man caused an urethral catarrh in the 
dog, which however did not persist for any great length of time. 

Diagnosis is based on frequent and painful urination in jets, 
tenderness of the urethra under palpation or catheterization, red- 
ness and swelling round the urethral orifice, and the oozing of 
pus. In the absence of any external injury one should always 
ascertain if cystitis is present. 

Prognosis is favorable under appropriate treatment. Spon- 
taneous recovery will usually occur early. 



Wounds of the Urethra, 265 

Treatment, Dilute the urine. Give pure water to drink at 
will, or flaxseed gruel, or gum or barley water. Alkaline car- 
bonates. In the early stage foment and use injection of potassium 
permanganate (2 grs. to i oz.). Later may be used more 
astringent agents (boric acid i : 100, zinc sulphate i : 100, lead 
acetate i : 100, p6tass chlorate 3 : 100. In the presence of great 
pain cocaine muriate 2 : 100). There is danger of stricture from 
the stronger astringents or caustics in the early stages before sup- 
puration. To complete the cure give copiaba, buchu, resin, or 
essence of turpentine. 



WOUNDS OF THE URETHRA. 

Acual wounds occur in surgical operations, or accidentally as 
by shafts, poles, forks, hooks, bites, etc., or from calculus or a 
catheter forced into a false route. An arrested or slowly moving 
calculus has been known to induce several perforating ulcers 
causing infiltration of urine and infecting germs into the connec- 
tive tissue. This determines rapidly increasing oedematous fluctu- 
ating tumors. Gangrene and septic intoxication are common re- 
sults, especially in cattle. 

•Longitudinal wounds keep more open and heal more readily 
than transverse wounds, probably because the circular muscular 
fibres in contracting, pull the edges apart and counteract stricture, 
the breach being filled up by granulations.- The perineal wound 
in lithotomy will heal thus in 20 days, while that made in ampu- 
tation of the penis is exceedingly liable to circular contraction 
and stricture or occlusion. 

Contusions of the perineum, may cause lacerations of the urethra 
and haemorrhages, with bloody discharge or sanguineous swelling. 

Treatment. Will vary. Calculi must be diagnosed and removed. 
Breach of the walls of the urethra may necessitate frequent 
catheterization or, better, the wearing of a catheter. Escape of 
urine into the connective tissue should be met by a counter open- 
ing in the skin to drain the part and allow free antisepsis. Simi- 
lar resorts are required for urinary infiltration, accompanied by 
antiseptic injection subcutem. Abscesses must be located, punc- 
tured with trochar and cannula, evacuated and injected anti- 
septically. 



FOREIGN BODIES IN THE URETHRA. 

Apart from calculi, may be found straws, glumes, chaff and 
catheters and even stones and small bodies which must have been 
introduced deliberately. An irritation corresponding to the offend- 
ing mass and its seat, ensues, and must be treated by soothing 
and anti-phlogistic measures while the offending body must be 
found and completely extracted. 



STRICTURE OF THE URETHRA. 

This may be suspected when in spite of much straining the 
urine is habitually passed in a very fine stream, which has be- 
come finer and finer for a length of time, without complete arrest 
as in calculus. The introduction of a catheter will confirm the 
diagnosis and show the exact seat of the stricture. 

It is determined by irritation caused by calculus, urethritis, 
ulcer, wounds, etc. , which tend to the formation of a cicatrix en- 
circling and narrowing the canal. One efficient cause is the in- 
jection of strong astringent or slight caustic solutions in the early 
stages of urethritis. 

Treatment is by dilation, by bougies pointed and gradually 
thickening, or simply by an elastic staff which at first passes with 
some force and is replaced by a larger one as the urethra stretches 
under daily use. 

Catheterization. In connection with diseases of the bladder 
and urethra the passing of the catheter is a most important opera- 
tion which requires considerable skill on the part of the operator. 
A short statement of the method to be adopted for each of the 
domestic animals will therefore be in place. 

Catheterization in the male Soliped. The catheter, a hollow,, 
gum elastic tube, must be proportioned to the size of the animal, 
but for the average adult horse about 3j4 feet in length and ys 
inch in thickness. To give it the requisite solidity and resist- 
ance it is usually furnished with a stilet of whalebone or cane. 

The operation is performed with the animal standing, in quiet 
266 



Stricture of the Urethra, 267 

animals without any restraint, but in the more sensitive or 
restive, with one fore foot held up ; or with both hind feet in 
hobbles furnished with ropes passing between the fore limbs and 
tied over the neck in front of the withers ; or finally with a 
twitch on the nose. 

The rectum is emptied, and with the oiled or soapy hand the 
penis is found and slowly withdrawn from the sheath by steady 
traction. This is usually easy, though in certain cases, with a 
short penis and specially strong retractors, it will seriously tax 
the operator's skill and address. In a specially obstinate case a 
hypodermic injection of morphine may be resorted to. 

If the horse is down, as in paraplegia or haemoglobinaemia, he 
may lie on his right side while the operator stoops over him from 
the loins ; or his feet may be drawn together by hobbles, and the 
subject turned on his back, the operator placing himself as before 
on the left side. 

The catheter must have been previously cleansed and disin- 
fected outside and in. A mercuric chloride solution i :20oo, or 
boric acid i : 50 or permanganate of potash i : 50 may be em- 
ployed. Then it must be smeared, preferably with vaseline 
but, in case of necessity, with sweet oil, glycerine, borated lard, 
of even castile soap. 

The penis being withdrawn from the sheath, the catheter con- 
taining its stilet is introduced into the urethra and pushed on 
slowly and carefully until its point can be felt over the ischiatic 
arch. The stilet is now drawn out a few inches and the point of 
the catheter is bent forward over the ischium by the finger. The 
stilet is further drawn out and the catheter can easily be 
pressed on into the bladder. If any difficulty is experienced it 
may be guided by the hand introduced into the rectum. 

In a number of cases, I found that the catheter entered a 
dilated seminal vesicle and failed to evacuate the bladder. This 
untoward occurrence must be rectified by the aid of the hand in 
the rectum. Usually the penetration of the bladder is signalized 
by the overcoming of resistance, and when the stilet is withdrawn 
the urine flows in a steady stream. If it fails to flow, a slight 
compression of the fundus of the bladder by the hand engaged in 
the rectum will start the stream. 

The catheter should be withdrawn slowly and carefully. 



268 Veterinary Medicine. 

Catheterization in the Bovine Male. Most veterinarians 
suppose that this is impossible, owing to the narrowness of the 
sheath interfering with the extraction of the penis, and the S 
shaped curve in the penis preventing the introduction of the 
catheter. Both obstacles can, however, be overcome in many 
cases. The bull may be tempted to protrude the penis by the 
presentation of a cow in heat, or in bull or ox the bulging 
anterior part of the organ may be protruded by careful manipula- 
tion through the sheath. Then the free extension of the penis 
can be made to eflFace the S shaped curve. The catheter must be 
small, not much over a line in caliber, and a metal stilet is em- 
ployed. The animal may have to be placed under restraint, and 
the same antiseptic precautions are demanded as in the horse. 

Catheterization in the Ram and Wether. These must be 
dealt with like the bull, the only additional diflSculty being in the 
vermiform appendix. This is small and sinuous but the longitudi- 
nal opening on its lower surface is favorable to the introduction 
of the catheter. 

Catheterization in the Dog. The fact that the urethra 
traverses the groove on the lower aspect of the bone of the penis, 
is held to prove an obstacle to the catheter, yet the introduction 
of the later is in no sense difficult. Small or moderately sized 
dogs, may be held upright, the body resting on the rump and the 
pelvis inclined forward, which will favor the spontaneous pro- 
trusion of the penis. Or it may be pressed out by manipulation 
through the sheath. The catheter ^ ds. to i line in diameter 
may be i^ to 2 feet in length according to the size of the animal. 
It should be used aseptic. 

Catheterization of the Mare. Nothing can be easier than 
this operation in the mare. The shortness and dilatability of the 
urethra, and the accessibility of its external orifice in the center 
of the floor of the vulva, 4 or 5 inches in front of the lower commis- 
sure, favors the introduction of the catheter. The latter may be a 
foot in length, perfectly straight and it may be constructed of silver 
or some other metal, which may be readily boiled and rendered 
aseptic. In the absence of a catheter the germ free nozzle of a rectal 
syringe may be used, or two fingers may be passed through the 
urethra and parted from each other so as to allow the exit of the 
urine. 



Acute Prostatitis and Hyperemia of the Prostate, 269 

Catheterization of the Cow and Heifer. The operation is 
often very difficult in the cow, by reason of the small size and un- 
dilatability of the urethra, and by the presence of two blind ducts 
(canals of Goertner) above and to the two sides of the urethral 
opening. The thin rigid upper margin of the orifice projects 
down over it in a valvular manner so that the catheter will almost 
always find its way into one of the blind sacs. By introducing 
the tip of the index finger beneath the valvular fold and into the 
opening of the canal, the catheter may be directed beneath it and 
into the bladder. An apparatus consisting of a series of ribs of 
spring wire arranged in the form of a funnel and converging at 
one end to a point has been devised to insert into the urethral 
orifice, and guide the catheter which is passed through it. A 
metallic catheter cut off obliquely at its point will enter easily. 

Catheterization of the Bitch. The operation is rendered 
difficult by the narrowness of the passage, and the puckers and 
folds of the vaginal mucosa which serve to hide the urethral ori- 
fice. A small catheter like that used on the male is used or a 
short metallic catheter may be substituted. By directing this 
forward exactly in the median line of the floor of the vulva, 
with gentle pressure downward it may be made to enter the 
urethra. In case of special difficulty a bivalve speculum may be 
resorted to, to efface the mucous folds and reveal the orifice. 



ACUTE PROSTATITIS AND HYPEREMIA OF THE 

PROSTATE. 

Causes : In dogs, house life, overfeeding, compulsory retention of urine, 
and faeces, constipation, proctitis (rectitis), piles, calculi, strangury, uric 
acid, urethral ulceration or stricture, rude catheterization, chill, generative 
excitement to excess, secondary abscess or infection. Forms. Lesions : fol- 
licular, interstitial, circumscribed and diffuse suppuration. Symptoms : 
frequent straining urination, rectal palpation, incontinence of urine, cos- 
tiveness, tender perineum, dullness, recumbency, fever, pus in urine, col- 
lapse of swelling, fistula. Diagnosis. Prognosis : grave. T? eatment : lax- 
atives, mercurials, salines, leeches, acid laxative, non-ttimulating, camphor, 
bromides, ergot, witch hazel, opium, belladonna, enemata of cold water, or 
ice suppository, catheterization, perineal incision, anti-septics. 

Causes. This is most commonly seen in dogs, in which it may 



270 Veterinary Medicine, 

depend on house life with overfeeding on stimulating, spiced, 
albuminous food, compulsory restraint of urination and defeca- 
tion in obedience to the demands of cleanliness, distended bladder, 
and rectum, constipation, proctitis, piles, and other sources of 
local irritation. In all animals its origin is favored by the forma- 
tion or arrest of calculi in the prostate, the pelvic urethra or 
even the bladder ; by drug strangury from cantharides or other 
irritant diuretic ; by excess of urea, uric acid or other irritant in 
the urine ; by infection extending from the urethra or bladder ; 
by ulceration or stricture of the urethra ; by rude or incautious 
catheterization, or injection ; by exposure to cold ; and by local 
infection in pyaemia and other general zymotic disorders. Most 
of these conditions conduce to local excitement and hyperaemia, 
which from adjacent organs, are sympathetically transferred to 
the prostate. The same is true of frequent, and intense genera- 
tive excitement which according to Lafosse and Cadiot is a com- 
mon cause of prostatitis in stud horses. Again the abscess of 
strangles, may become localized in the prostate, or the nodule of 
glanders, or the tubercle of tuberculosis (cattle, pigs, dogs). 
Cadiot suggests that in animals, divested of the tail, external 
injuries to the perineum may extend by continuity to the prostate, 
as happens to man from horseback or bicycle riding. He adduces 
no cases however. The habit of masturbation acquired by cer- 
tain males may also be adduced theoretically as both cause and 
consequence of prostatitis but future observation must show how 
frequently this really operates. 

Forms. Lesions. According to the nature of the lesions the 
affection has been divided into different forms : ist. Follicular or 
Parenchymatous ; 2d, Diffuse or Interstitial ; 3d, Circum- 
scribed Prostatic Abscess ; 4th, Multiple Miliary Abscesses. 

Follicular Prostatitis implicates primarily the follicles and 
gland ducts and finally the entire gland tissue. It is usually 
associated with and doubtless often proves an extension from an 
adjacent infective urethritis, and tends, in persistent cases, to go 
on to interstitial inflammation and abscess, or hypertrophy. This 
is characterized by more or less swelling of the prostate, with 
increased vascularity of its mucosa and the oozing from its open- 
ings and gland ducts under pressure, of a thick, yellow, gelatinoid 
fluid containing pus and granular epithelial cells and sometimes 
striae of blood. 



Acute Prostatitis and Hypentmia of the Prostate. 271 

Diffuse (Interstitial) Prostatitis shows, in addition to the 
general swelling and muco-purulent discharge, a considerable 
exudate into the interstitial tissue, with increased tension and 
resistance of its substance. It is associated during life with more 
fever and constitutional disturbance than th^ simple catarrhal or 
follicular form. 

In Circumscribed Prostatic Abscess we find, in addition to 
the general hyperaemia and swelling, a much more prominent 
local swelling, the seat of intense inflammation, at first firm and 
resistant and later softer and fluctuating in the center, which is 
filled with pus. This may have its origin in the follicular form, 
the pus becoming shut up in a follicle and gradually increasing 
until it bursts into the urethra, the bladder, the rectum, the peri- 
toneum, or pelvic fascia and perineum. In other cases it becomes 
complicated by pyaemia and secondary abscesses. 

Miliary Abscesses may be comparatively few in number or 
generally diffused through the prostate, and are often the result 
of a pre-existing general infection. 

Symptoms. As the disease usually begins as a local infection 
the first symptoms are, as a rule, unattended by fever, which, 
however, appears in two or three days as the local lesions in- 
crease. The urine may be passed frequently in small amounts, 
or there may be frequent straining without passage of urine, the 
pressure of the swollen prostate, with or without spasms of the 
sphincter vescicse, causing retention. It is no uncommon thing 
to find the last urine passed of a milky or glairy character and, 
coagula moulded in the prostatic canals may at times be found. 
The presence of spermatic crystals, fusiform, with very pointed 
extremities, and precipitated on the addition of ammonium phos- 
phate, is characteristic of prostatic fluid. (Fiirbringer). In 
other cases there is incontinence, the urine^ dribbling away in- 
voluntarily as the animal walks, and especially if anything occurs 
to excite him. Micturition may be painless or attended by acute 
suffering, which causes a sudden arrest of the flow. Defecation 
is attended with difficulty and more or less pain, and obstinate 
constipation is likely to set in. The animal is dull, spiritless and 
seeks to lie undisturbed. Pressure on the perineum is painful 
and exercise aggravates the symptoms. Rectal examination by 
the hand or finger according to the size of the animal, reveals 



272 Veterinary Medicine, 

the enlarged, tender prostate lying on the cervix vesicae. This 
swelling may be unilateral but most commonly it is bilateral or 
general. When fever sets in with a temperature of io2°-io4°, 
thirst, anorexia and weakness or stiffness in the hind parts may 
be noticed. In case of abscess, the urine may be perfectly clear 
until it bursts into the urethra or bladder when there is an 
abundant flow of pus, and rectal examination shows that the 
swelling and tension have notably diminished. Should it burst 
into the rectum, the pus shows in the faeces. Reinemann records 
a case in a bull with dysuria, oedema of the sheath and a swel- 
ling like the fist in the perineum, containing pus, and which 
communicated with the prostate and urethra. With the rupture 
of the abscess there is a marked amelioration of the symptoms. 

Not infrequently the affection subsides into the chronic form 
and the abscess, having a restricted channel for evacuation, re- 
mains as a suppurating cavity. 

Diagnosis. The enlargement and tenderness of the prostate 
as felt on rectal examination is pathognomonic. If the body of 
the urine is clear there is further corroboration, as in C3'stitis it 
is more or less turbid and flocculent or even bloodstained. Mic- 
turition is likely to be much more frequent in cystitis than in 
prostatitis. Catheterization is much more painful when the 
catheter passes the prostate in prostatitis than in cystitis. 

Prognosis is always grave. Some cases recover completely, 
while others run on to a fatal termination, and still others merge 
into the chronic form. Cases that are complicated by abscess are 
always to be dreaded, as chronic suppuration, or pelvic or perito- 
neal infection, or pyaemia, or septic poisoning is liable to super- 
vene. As the disease is more common in the old so it is liable to 
prove more severe and redoubtable. 

Treatment, In acute cases active derivation toward the bowels 
is desirable. A mercurial purge (calomel — horse or bull i to 2 drs ; 
dog, 2 to 5 grs. ) may be followed a few hours later by salines 
(sodium sulphate — horse or bull i lb. ; dog i oz.). Sodium sul- 
phate or magnesium sulphate may also be given with glycerine as 
an enema. Great benefit may often be obtained from the applica- 
tion of leeches on the perineum or around the anus. The diet 
must be restricted and non-stimulating, mainly of amylaceous 
materials, and with the water, flaxseed tea may be liberally 



Chronic ProstaHHs, 273 

mixed. When the suffering is severe it may be met by camphor, 
camphor bromide, ergot, hamamelis, gelsemium or potassium 
bromide, given by the mouth or rectum. With violent strangury, 
opium, belladonna or hyoscyamus may be tised. Some cases may 
be relieved by the use of enemata of cold water, or pieces of ice 
in the rectum. In retention of urine, careful catheterization is 
imperative, the hand or finger in the rectum being employed to 
guide the point of the catheter under the prostate. 

In case of abscess an opening by the side of the anus is prefer- 
able to one by the urinary passages or rectum, and will obviate the 
danger of rupture into the peritoneum. A pasty or fluctuating 
swelling in the perineum should be incised until the pus flows. 
A tense elastic fluctuating prostate may be transfixed by a can- 
nula and trochar from the side of the anus, guided by the hand 
or finger in the rectum. When the pus has been evacuated 
a drainage tube may be inserted through the cannula and 
left in place when the latter is removed so as to allow 
free drainage at all times and frequent antiseptic injections. 
Punctures and even incisions have been made from the rectum, 
but they make badly infected wounds, and a rupture into the 
urethra, determines infection on that side, without any possibility 
of any effective antiseptic injection or perfect drainage. As in- 
jections may be used permanganate of potash i : loooo, or boric 
acid, a saturated solution. Poisonous agents must be eschewed 
or used with the greatest circumspection. 



CHRONIC PROSTATITIS. 

Causes. Pollows acute. Same caujtes leas potent. Lesions : as in acute, 
or sclerosis, and abscess. Symptoms : delayed urination, last glairy or 
purulent, constipation, defecation followed by urethral discharge, little 
genital ardor, rectal pa1pati>ii, tenderness of prostate to hand or catheter, 
atony of hind limbs. Treatment : open air life, idle, milk or succulent diet, 
saline laxatives or enemata, avoid generative excitement, castrate, check 
masturbation, iodine, camphor, antiseptic irrigations. 

Causes, The acute disease often subsides leaving an indolent 
chronic inflammation of the organ. Apart from this, the causes 
18 



274 Veterinary Medicine, 

are essentially those of the acute, but acting with lessened force 
or on a less susceptible system. Thus indoor life and overfeeding, 
with constipation and urine of a high density, calculus, irritant 
diuretics, the frequent incautious use of the catheter, infection 
from the catheter or otherwise, intense and frequent generative 
excitement, and exposure to cold are all occasional factors. Old 
age is a common concurrent cause. 

Lesions, As in the acute form these indicate three successive, 
independent or concurrent forms, follicular, interstitial and sup- 
purative. 

With the distinctly follicular form the gland is usually en- 
larged and of a deep red color, but soft and friable, and when 
compressed exudes from its follicles and gland ducts a whitish 
muco-purulent glairy liquid. With the interstitial changes, 
which are often an advance on the follicular, the organ may be 
enlarged or shrunken, but the connective tissue has undergone a 
thickening and sclerosis which renders the mass firm and re- 
sistant, and which may have extended to the tissues in the im- 
mediate vicinity. ' In the suppurative form or stage, foci of 
suppuration are found throughout the gland substance, bulging 
out on its surface and even encroaching on surrounding tissues. 

Symptoms. These are by no means obtrusive. There may be 
some delay in the discharge when the animal attempts to urinate, 
and the last drops of the urine, white and purulent or glairy, may 
be passed with evident pain. There is a tendency to constipa- 
tion with painful straining to defecate. Compression of the 
prostate during defecation presses out its muco-purulent contents 
so that there is a greater urethral discharge following this act 
than at other times. This is also more abundant from the com- 
pression of the abdomen when the animal is lying down. This 
discharge is easily distinguished from semen by the absence or 
almost complete absence of spermatozoa and the abundance of 
spermatic crystals, precipitated by ammonia phosphate. In the 
earlier stages there may be undue generative excitement, erec- 
tions, and even seminal discharge, with or without the move- 
ments of masturbation but in advanced cases genital ardor is 
usually defective or there may be practical impotence. Con- 
clusive evidence is obtained by rectal exploration, when the en- 
larged, or irregularly shaped and tender prostate can be easily 



Chronic Prostatitis, 275 

recognized. If a sterile catheter is passed, the pain caused as 
it touches the prostate is significant. 

In the dog the afFection may last for years, and tends to 
advancing atony of the hind limbs. A temporary arrest of the 
affection is often misleading, though the urine may be clear and 
normally discharged, yet manipulation ' may show a gradually 
advancing abscess, and when this bursts, usually into the urethra, 
all the symptoms become aggravated and cystitis, urethritis 
and general infection are to be dreaded. 

Treatment, This is far from satisfactory yet in certain purely 
follicular or catarrhal cases it may prove successful. An open 
air life, without exertion, and a milk and farina diet are de- 
sirable, yet any tendency to costiveness must be obviated by 
saline laxatives and enemata. The avoidance of generative ex- 
citement must be secured, not only by restraining stud animals 
from service, but by keeping them well apart from all females 
of the same species. Even castration may be sometimes re- 
sorted to with advantage. Stallions given to masturbation must 
be restrained by net or otherwise. Any disease of the rectum, 
anus, urethra or bladder should be corrected, and undue ex- 
posure to cold prevented. Lafosse advises to slaughter butcher 
animals for food. Hertwig recommends iodine ointment on the 
anus and perineum of affected dogs. It must be borne in mind 
that the affection is maintained by infective microbes yet it is 
diflScult to reach and deal with these thoroughly and effectively. 

As an anaphrodisiac may be given camphor, or camphor bro- 
mide, ergot or potassium bromide, along with the mild stimulating 
antiseptic eucal3rptol, piperazine or copaiba. But the irrigation of 
the urethra, bladder and as far as pos.sible the prostate with such 
antiseptic solutions as potassium permanganate (i : loooo) or 
silver nitrate (0.5 to i : 100) or zinc chloride (i : 100) is desir- 
able. These should be injected into the urethra so as to reach the 
bladder, the contents of which they will render antiseptic and thus 
protect the organ against the transported microbes of the prostate. 
In man iodoform, europhen, and ichthyol are made into a bougie 
with gum, palm butter or other soluble liquefiable agent and in- 
serted in the urethra as far as the prostatic part. Similar agents 
are used as suppositories or enemata. Hertwig' s iodine ointment 
on the perineum may be advantageously replaced by sinapisms. 



HYPERTROPHY OF THE PROSTATE. 

In old dogs. Causes : age, overfeeding on albuminoids, rectal impaction 
or irritation, calculus, cystitis, urethritis, productive inflammation, trophic 
derangement when function declines. Lesions : hypertrophy general or 
partial, hard or soft, condensed or with sacs of pus, red or pale Infective 
cystitis. Calculi. Symptoms : straining before urine comes, small or weak 
stream, sudden check, last part purulent or nmcous, incontinence, triple 
phosphate, ammoniacal odor, crystals and dark color imply calculus. Diag- 
nosis : by rectal exploration, and catheterization. Treatment ; palliative, 
moderate, farinaceous, laxative diet, warmth, correct contiguous troubles 
Iodine, castration, extirpation of prostate. 

This has been seen almost exclusively in old dogs, among the 
domestic animals. 

Causes. Age and good living, more particularly on highly 
albuminous food, may be adduced as the most prominent. Per- 
haps even more important are continued irritation in adjacent 
organs such as the rectum, bladder and urethra. It is the old, 
pampered dog that above all suffers from atonic, overloaded 
rectum, proctitis, piles, calculus, cystitis, and stricture, and the 
constant local pelvic congestion caused by one or other of these 
tends to a hyperplasia of the prostate. Again atheroma which is 
especially a disease of the aged is regarded as a cause of both 
cystitis and prostatic h5T)ertrophy. Chronic inflammation in the 
prostate has been claimed as a factor, but contested on the ground 
that inflammation never increases normal growth though it may 
cause degeneration. The exudate of inflammation, tends, how- 
ever, on its temporary arrest, to undergo organization, and such 
organization inclines to assume the structure which is normally 
built up by the adjacent trophic cells. The products of inflam- 
mation may, therefore, well contribute to hypertrophy, and above 
all to the increase of the simpler tissue represented by the fibrous 
framework of the gland. The congestion attendant on excessive 
venery has also been incriminated, and this too has been denied 
on the ground that the h5T)ertrophy is not found in the young 
animals and men in which the generative ardor is greatest and 
most frequently aroused and gratified. Thompson's idea is that 
the prostate, like the ovaries and womb, is especially prone to 
276 



Hypertrophy of the Prostate, 277 

morbid growths and developments at the time when in advancing 
age, the normal generative functions are undergoing a rapid 
decline. The two conditions may well be recognized without con- 
sidering them as mutually excluding each other as causative 
factors. 

Lesions, The enlargement is usually general, but it may pre- 
dominate in the right, left or median lobe, the latter as a rule 
exercising greater compression of the urethra so that this is often 
marked in the worst cases. The hyperplasia may feel firm and 
resistant or it may be more or less soft from sacs of muco-puru- 
lent fluid imprisoned by the obstruction of the outlet canals. 
On the surface and on section the general appearance of the 
gland is pale, bloodless and uniformly solid. This comes from 
the great hypertrophy of the fibro-muscular stroma which has in 
many cases compressed the parenchymatous or secreting struc- 
ture so as to cause its atrophy. The presence of calculi (mainly 
phosphatic) in the follicles is not uncommon. 

The complication of infective cystitis is frequent, the congestion, 
redness, ecchymosis, maculation, puckering and thickening of 
the mucosa, the granular degeneration and desquamation of the 
epithelium, the exposure of a raw vascular surface, the dis- 
coloration of the urine by mucus, pus and blood, and the forma- 
tion of ammonia and other products of decomposition, becoming 
marked phenomena. Vesical calculus is not uncommon, the 
slowness of the exit current of the urine retarded by the en- 
larged prostate, tending to prevent its impaction in the orifice 
and thus minimizing one of the most prominent symptoms. 

Symptoms, Among the earliest symptoms, is some modifica- 
tion in the act of micturition. Straining a few seconds before 
urine comes, retention, incontinence and dribbling, discharge in 
a small or weak stream, and sudden arrest of the flow and the 
last few drops may contain muco-pus showing abundance of sper- 
matic crystals, on the addition of ammonia phosphate. Impac- 
tion of the rectum tends to occur sooner or latter, the animal 
making little effort to unload the viscus, and the overdistended 
organ becoming more and more atonic, congested and catarrhal 
and reacting injuriously on the urinary organs. Incontinence 
may be especially marked during sleep, the sphincter being suf- 
ficiently controlled by volition during waking hours. Retention 



278 Veterinary Medicine, 

may be at first temporary from excitement and later more con- 
tinuous by reason of the greater compression of the neck by the 
enlarged and indurated prostate. With the advance of the dis- 
ease the urine shows abundance of triple phosphates, and be- 
comes ammoniacal and foetid. A dark or bloody color of the dis- 
charge and the presence of crystals suggest calculus. 

An accurate diagnosis can only be had by rectal examination. 
The great enlargement of the prostate, in the absence of heat 
and tenderness is characteristic. Enlargement is usually uni- 
form, though it may be concentrated on the right, left or central 
lobe. The passage of the catheter may be obstructed, but is not 
specially painful at the prostatic region as in prostatitis. From 
vesical calculus it is distinguished by the fixity of the swelling 
on the neck of the bladder as contrasted with the mobility of the 
stone inside that half- filled organ. From stricture it is differen- 
tiated by the fact that the obstruction offered to the catheter and 
the swelling of the prostate exactly correspond in position, that 
the stream is lessened in force rather than simply reduced in size, 
and that the history of the case shows no antecedent cause for 
stricture. 

Treatment, This has been considered as mainly palliative. 
Special care of the general health and above all of the diet which 
should be moderate, farinaceous and laxative, protection against 
cold and wet, the correcting of any coexisting trouble of the 
urinary or generative organs, and the removal from all sources of 
generative excitement are important elements. Occasional small 
doses of Epsom or Glauber salts in draught or enema obviate 
rectal hyperaemia. Ergot, potassium iodide internally, and iodine 
or mercurial ointment to the perineum have had little good effect. 
Moller claims to have secured improvement from the injection 
into the prostate at intervals of fourteen days, of a solution of two 
parts each of tincture of iodine and iodide of potassium, and sixty 
parts of distilled water. A small hypodermic syringe is used and 
the injection is made through the rectum directly into the sub- 
stance of the prostate. Glass has adopted the recent surgical 
alternative of castration, with the result of marked relief from the 
active symptoms in a number of cases, but with a more rapid 
advance through emaciation and marasmus to death in three or 
four weeks in others. We would suggest a careful antiseptic 



Tuberculosis of the Prostate. 279 

castration in such cases, to obviate any added trouble from ab- 
sorbed toxins or sepsis. 

For the human subject, Lydston strongly advocates removal of 
the enlarged prostate by surgical means in strong, vigorous sub- 
jects, with healthy bladder and kidneys. The difficulty of such 
an operation in the dog is greatly enhanced by the relatively 
greater length of the pubio-ischiatic symphysis, and the lessened 
diameter of the pelvic cavity. Yet with the comparative 
immunity of the dog from suppuration, and the hopelessness of 
the case without such radical measure, and with the rigid applica- 
tion of an antiseptic technic, the operation would appear to be 
fully justified. It would be contra-indicated in all advanced cases, 
in which the prostate was the seat of active suppuration with dis- 
charge into the urethra, in cases complicated by urethritis, cystitis 
or nephritis, in cases in which there is marked prostration from 
sepsis or absorbed toxins, and generally in old, worn out and 
cachectic animals. 

Short of this, in cases complicated by cystitis, antiseptics by 
the stomach and as injections into the bladder are desirable. 
Eucal5rptol in doses of ten minims four times a day, or piper- 
azin 15 grs., or beta naphthol, guaicol, or phenol have been 
used in man. As injections mercuric chloride i : 20,000 ; boric 
acid, saturated solution ; or carbolic acid .5 : 100 (Lydston) may 
be used warm several times a day. 



TUBERCULOSIS OF THE PROSTATE. 

This is a common seat of tubercle in generalized tuberculosis 
in cattle, and may give rise to the same urinary troubles as 
chronic prostatitis or hypertrophy of the organ. In a remarkable 
case recorded by Frauenholz the tuberculous prostate of an ox 
weighed io>^ lbs. and had contracted adhesions to surrounding 
pelvic organs. Section of the mass showed numerous centres of 
extensive caseous degeneration. In such cases the generalized 
tuberculosis is the important fact and the prostatic disease is only' 
an unusually intractable complication. If less generalized, the 
implication of the testicle or epididymus is strongly suggestive, 
and examination of the urine may detect the tubercle bacillus, or 
the tuberculin test may develop the characteristic febrile reaction. 



CANCER OF THE PROSTATE. 

Lafosse records as colloid cancer a case of diseased prostate in 
an ox, in which the mass approximated to the size of the human 
head, and was made up of numerous cavities the largest not 
over lyi inch in diameter, and all intercommunicating, and con- 
taining a gluey, or gelatinoid liquid with numerous small round 
cells and a few multinucleated giant cells. No evidence is given 
of the implication of even the adjoining lymph glands, so that 
the case was probably only an enlarged cystic prostate. 

Fournier records a case in a three year old horse, which on 
necropsy showed a ruptured bladder, general peritonitis, and an 
enlarged prostate, involving Cowper's glands. Nocard identified 
its cancerous nature by microscopic examination. Yet there is 
not a word of the implication of adjacent lymph glands. 

Goubaux says prostatic cancer is common in dogs. 



PROSTATIC CYSTS. 

These are not at all uncommon as a complication of hjrper- 
trophy of the prostate, the ducts having become obstructed and 
the follicles indefinitely distended. The case described by 
Lafosse as cancer of the prostate of a bull is strongly suggestive 
of such retention cysts. 



CALCULUS OF THE PROSTATE. 

Two forms of calculi have been found in the prostate in do- 
mestic animals : ist, small, round, angular or branched bodies 
made up in concentric layers and formed of organic nitrogenous 
bodies: and 2nd, genuine calculi of calcium phosphate or am- 
monia magnesian phosphate. These may cause pressure on the 
parenchymatous tissue and atrophy, but in the lower animals 
they are seldom the direct cause of prominent morbid symptoms. 
280 



Diseases of the Female Generative Organs. 281 

They must, however, be recognized as one of the causes of 
chronic irritation that contribute to prostatic inflammation and 
hypertrophy. 



DISEASES OF THE FEMALE GENERATIVE ORGANS. 

MALPOSITION OF OVARY AND WOMB. HERNIA OP THE OVARIES. 

Inguinal or crural hernia of ovary or womb. Bitch. Long uterine borns, 
loose broad ligaments ; Sow ; Bwe ; Cow. Other openings. Symptoms : not 
marked : strangulation : inflammation : abscess. Gravid hernial uterus. 
Treatment : reduction : surgical means : Caesarian section. 

The most common displacement of the ovary in the lower ani- 
mals is through the inguinal or crural arch. It is most frequent 
in the bitch doubtless for the reason that the horns of the womb 
are long, and widely separated from each other, and in any case 
of inguinal or crural hernia, or of undue dilatation of the openings 
they are liable to pass through. A relaxation of the broad lig- 
aments is another condition of such displacement. The laxity of 
these ligaments in the normal condition in the sow favors ovarian 
hernia, and Dupont found the ovaries in the perineal region in 
five sows examined, I^aux found the condition in ewes, and 
Mtiller in cows, one ovary lying on each side of the mammae. 
With relaxation of the uterine ligaments the hernia might occur 
in any female mammal, and not only through the orifices named, 
but through any normal or adventitious opening in the abdominal 
walls. 

Symptoms. In the bitch the hernia is often overlooked although 
an examination of the inguinal region will reveal the presence of a 
small nodule and vermiform body which may usually be returned 
into the abdominal cavity. In some cases it becomes strangulated 
by the gradual contraction of the neck of the hernial sac, followed 
by swelling, heat and tenderness of the hernial mass, which may 
go on to abscess formation. In exceptional cases impregnation 
occurs with the womb in this position and the steady nodular in- 
crease of the mass, and finally the automatic movements of the 
contained foetuses become very characteristic. 

Treatment consists in passing the womb and ovary back into 
the abdomen, and if adherent or incarcerated, in exposing and 



282 Veterinary Medicine, 

releasing, and if necessary extirpating them. In case of advanced 
pregnancy with the gravid womb on the inner side of the thigh, 
a modified Caesarian operation is required without the attendant 
danger of laying the peritoneal cavity directly open. Inflamma- 
tion and abscess must be treated on general principles. 



UNDEVELOPED OVARIES. ABSENCE OF OVARIES. 

The absence of ovaries has been often noticed in twin heifers, 
and most commonly associated with deficiency or absence of the 
womb, and even at the anterior part of the vagina. The condi- 
tion is especially common, though not constant as some have 
supposed, when the other twin is a male. Such females are 
known zsfree martins and fail to breed. Even when the ovaries 
are present in such twins they remain undeveloped, and are no 
larger than a bean or hazel nut. These usually have a firm, 
fibrous structure, and though there may be interspaces filled with 
a transparent fluid, no true Graafian follicles are formed. In 
birds, the left ovary only is developed and physiologically active. 
The absence of ovary has been noted also in the ewe, and less 
frequently in the mare and other species, and appears to be more 
common in twins than in single pregnancy. In cattle only has 
the influence of the male on the female twin of the same preg- 
nancy been specially noted. 

It has been noted that females with ovaries undeveloped, tend 
to show many male characters, in head, horns, and neck in cattle, 
in plumage in birds, and in voice in both. 



ATROPHY OF OVARIES. 

This is observed as a physiological result of having passed the 
breeding age, and may also take place from disease and degene- 
ration of the organ. The fibrous stroma is usually increased and 
the cell elements reduced, yet in some cases, a cystic develop- 
ment occurs, giving the appearance of hypertrophy, while the 
ovarian parenchyma has actually been diminished. 



SUPERNUMERARY OVARIES. 

Extra ovaries have been found in different cases in the human 
female, the additional organ being furnished with a fallopian 
tube, and in some instances an extra uterine horn. No facts are 
at hand concerning the lower animals, but the occurrence of ges- 
tation and the birth of a single puppy a year after careful castra- 
tion, would seem to suggest that the condition occurs in the bitch. 
There is no embryological reason why the lower animals should 
not at times show this deviation from the normal. 



IRRITABLE OVARY. NEURALGIA OF THE OVARY. 

This has been noticed most cojoimonly in the mare, which 
from a quiet, docile animal, has become very ticklish, especially 
in the region of the flank, kicking on the slightest touch, or 
even when approached and showing an amount of nervous ap- 
prehension, that may render her useless, for work. The ovaries 
are usually found to be enlarged, diseased and very sensitive. 
CEstrum may be in some cases constant and excessive and in 
others entirely suspended. Such cases are diflScult or dangerous 
to shoe. In one case recorded by Thierry, handling of the flank 
promptly induced an epileptic attack. Cows with nympho-mania 
(bullers) are often victims of this condition. The only remedy 
is castration, which is best performed by the vagina. The shorter 
the period of the irritability the more perfect is the cure. In 
some old standing cases the vicious habit may have become so 
fixed, that it is continued in spite of the operation. 



283 



HEMORRHAGE ON THE OVARY. 

Mare and Cow : genital excitement, mechanical injury, diseased ovary in 
nnimpregnated, ovulation with bleeding, falls/ slings. Lesions : old de- 
generations, productive inflammation, varicosities, aneurisms, torpid vessels, 
blood staining, clots, follicular or not, ruptures into peritoneum, amount, 
microbes usually absent. Symptoms : obscure, arched, stiff loins, colics, 
recumbency, large tender ovary. Shivering, fever, anorexia, anemia, sur- 
face coldness, unsteadiness, blood from vulva, liquid in abdomen fluctuates. 
Treatment : cold, ice, snow, on loins, cold acid drinks, tannin, iron chloride, 
matico, gelatine subcutem, atropin, ergotin, viburnum, derivatives, castra- 
tion. 

This has been seen in the mare and cow especially in connec- 
tion with genetic excitement and mechanical injuries, and more 
especially pre-existing disease of the ovary. Trasbot notes that 
it has always been in the absence of pregnancy, a fact which we 
can easily explain on the grpund that most active diseases of the 
ovary render the animal barren. Gestation like castration, calms 
the genetic instincts, and prevents the recurrence of oestrum with 
its vascular excitement, general and ovarian, which characterizes 
the nnimpregnated condition. The normal rupture of the 
Graafian follicle and escape of the ovum is attended by some 
effusion of blood which passes through a series of changes pre- 
paratory to absorption. A more extensive bleeding, at the time 
of oestrum or othervsdse, into a follicle or intrafoUicular, and with 
or without rupture of the albugenic tunic constitutes the morbid 
haemorrhage. Among mechanical causes may be named violent 
exertion, falls, and suspension in slings. 

Lesions, Some cases in mares and cows show old standing 
lesions, to which the extravasation is secondary : a productive 
inflammation of the ovarian stroma ; varicosity of the ovarian 
veins ; aneurism of the utero-ovarian artery ; the presence of 
emboli or thrombi. In the area of the effusion there is a general 
turgescence of the vessels, and blood staining of the stroma. Or 
there are distinct blood clots in the follicles or between them, a 
few lines or an inch in diameter, buried in the depth of the 
organ, or standing out in rounded swellings on its surface, and 
sometimes with a rupture two or three inches in length, and the 
284 



HtEtnorrhage on the Ovary, 285 

escape of blood into the peritoneal cavity. This may be sufficient 
merely to stain the peritoneal fluid, or it may amount to one or 
two bucketfuls as in cases recorded by Barrow and Palat. In 
the absence of rupture the effused blood may completely surround 
the ovary, or may accumulate in one or several of its distended 
follicles. The" effused blood is rarely septic, being usually free 
from microbes, and it may remain fluid in the peritoneum, or 
coagulate in the ovary. The enlarged follicle may contain a 
dark red fluid, in which floats a solid clot, varying in color from 
dark red to light yellow, according to age. 

Symptoms, These vary greatly with the extent of the lesion, 
and are always somewhat obscure. With slight interstitial or 
intra- follicular effusion, there may be only some general disorder, 
with, it may be, arching and stiffness of the loins, colicy pains, 
a desire for recumbency, and enlargement and tenderness of the 
ovary on rectal examination. In more severe cases as noticed 
by Cordonnier, Saucour and Palat in mares, by Lapons^e in the 
ass, and Renault in the cow, there were shivering, h5T)erthermia, 
respiratory and cardiac acceleration, congested mucosae, dull 
colicy pains, and anorexia, followed by indications of anaemia, 
small, weak, rapid pulse, pale mucosae, coldness of ears and legs 
(in cows, of muzzle and horns), violent heart action, indisposition 
or inability to rise, unsteadiness on the limbs when up, and in 
some cases the escape of blood from the vulva. By rectal ex- 
amination the enlarged, tender, doughy ovary may be character- 
istic and the fluctuation of liquid in the peritoneal cavity, which 
may also be recognized by manipulation of the flank. 

Treatment, This should be directed toward checking the haem- 
orrhage : Cold water or ice, on loins or flank ; injections of cold 
water : cold water or acids or astringents by the mouth : tannic 
acid : iron chloride : matico : gelatine : atropine, ergotin. By way 
of quieting ovarian excitement, viburnum prunifolium or opium 
may be tried. Sterilized solutions of gelatine may be given sub- 
cutem. Mustard or ammonia may be applied to limbs or flank. 
In case of survival, castration will be indicated. 



INFLAMMATION OF THE OVARIES. OOPHORITIS. 
PERIOOPHORITIS. 

Mares, cows, sows, etc. Causes : traumas, cestnun, parturition, leucor- 
rhoea, pus infection, strangles, dourine, glanders, abortion, tuberculosis, 
chill, poisons. I,esions : Ovary enlarged unequally, red, congested, exu- 
date, extravasations, fibroid, caseated, purulent, abscess single or multiple, 
indurations, cretefactions, cysts, blocking of .Fallopian tube, adhesions. 
Symptoms : mare : genital erethism, soiling of vulva and tail, colks, tender 
loins and mammse : fever, dullness, emaciation, decubitus, paraplegia, 
swollen tender ovary : cow bellows, paws. Sterility, anaemia, pyaemia. 
T/eatment : Cold to croup, mustard, anodynes to vagina, calmatives anti- 
septics. Castration. 

This has been frequently seen in mares, cows and sows, but it 
may occur in any of the female mammals or even in birds. 

Causes, The condition has been ascribed to blows on the flanks, 
pressure on the abdomen and the congestion of the ovary which 
attends on frequent oestrum in the absence of the physiological 
quiet which comes from conception. In a large proportion of the 
cases, however, the attack has followed on parturition, abortion, 
a preexisting leucorrhoea or metritis, or a suppurating process 
in some other part of the body. These cases therefore, must be 
looked upon as secondary and infective, the microbes having been 
transferred from the womb, along the Fallopian tubes, or through 
lymph vessels, or peritoneal cavity, or finally through the circu- 
lating blood. In mares strangles, abortion, leucorrhoea, dourine 
and glanders, and in cows and sows abortion, metritis, leucor- 
rhoea, and tuberculosis, may prove the starting point of the in- 
fection. 

Sudden chills when heated, perspiring or exhausted and es- 
pecially exposure in inclement weather just before or after par- 
turition, have been regarded as effective causes, and doubtless 
these lower vitality and power of resistance, but back of these we 
must look for infection coming from the parturient womb. 

Bivort records an extensive epizootic of oophoritis in sows kept 
on waste ground which had been used for herding swine years 
before. He attributes the trouble to poisonous plants, without, 
286 



Inflammation of the Ovaries, Oophoritis, Perioophoritis, 287 

however, attempting to identify them, and the probability is even 
more strongly in favor of infection left over from the former 
herds. 

Lesions, The inflamed ovary is swollen slightly, or to a great 
size, in mare or cow like the fist or even an infants' head. The 
swelling, however, is unequal throughout, and the surface may 
bulge in rounded masses at different points. In the early stages 
the organ is firm, elastic, red and on the cut surface bleeding, 
with here and there a distended follicle with bloody or gelatinoid 
liquid contents. The exudate into the fibrous stroma may be- 
come coagulated, and later may be organized into fibrous sub- 
stance giving a hard resistant sensation to the finger (sclerosis). 
In some cases this may become partly cartilaginous. In other 
cases the distended follicles may have their contents coagulated 
and transformed into a caseous mass, while much of the stroma 
has become liquefied and absorbed. When suppuration has set 
in, the gland is softened at this point, the parenchyma giving 
way before the pus. The pus may be in multiple sacs, as if 
formed in the Graafian vesicles, or it may be in one undivided 
abscess. In the ovary of a cow, El^ouet counted no less than 
sixty-three separate abscesses. In cases complicated by ovarian 
glanders, tuberculosis or actinomycosis, the gross, microscopic, 
and mycotic characters of the lesions will afford the means of 
diagnosis. 

In chronic forms indurations, cretefactions, cystic degenera- 
tions, caseations, and sclerosis may be met with. 

Lesions in adjacent structures are common, such as thickening 
and stenosis of the Fallopian tube ; congestion, thickening and 
puckering of the mucosa in the adjacent part of the womb ; peri- 
tonitis ; adhesions of the ovary to the abdominal walls or to an 
adjacent organ. 

Symptoms, Mare, In many cases the early phenomena are 
those of excessive genital erethism : the animal is restless, fever- 
ish, whinnies to attract other horses, snuffs the males on their 
approach, contracts the vulvar muscles constantly, exposing the 
congested mucosa and clitoris, and ejecting a glairy liquid which 
soils the tail, hips, thighs and hocks. She strains frequently, 
passing small jets of high colored turbid urine, and rubs the tail 
and hips against available objects, twisting and breaking the hair 



288 Veterinary Medicine, 

and abrading and excoriating the surface. The croup may be 
alternately drooped and raised and the tail switched. These phe- 
nomena are not abated by copulation, nor by time, like ordinary 
heats, but will last for one or more weeks when a new set of 
symptoms set in. Meanwhile dull colicy pains cause restless 
movements, arched back, frequent moving from place to place, 
crouching by partial bending of the limbs, twisting of the hind 
parts from side to side. The loins are tender to pressure, and the 
middle of the flank to pressure or percussion. The mammary 
glands are usually hot, swollen and tender. The genital erethism 
may last from four to seven days. Then it subsides, with coinci- 
dent improvement of the general symptoms and a recovery ensues. 
Relapses are to be expected sooner or later. 

In fatal cases the erethism subsides, but fever, dullness and 
emaciation continue, the case becomes aggravated at intervals, 
weakness and exhaustion increase, decubitus may become con- 
stant or paralysis ensue. The patient dies in marasmus in one to 
three months. 

In some the genital erethism is absent from the first. There is 
dullness, prostration, anorexia, fever, hurried breathing, small 
rapid pulse, colicy pains, tender abdomen, difiBcult defecation, 
coated dung, a glairy (perhaps reddish or fcetid) discharge from 
the vulva, hot, tumid, tender mammae, arched and sensitive loins, 
and stiffness of the hind limbs. 

In all cases alike a rectal examination detects the ovary swollen 
and exceedingly tender. 

Cow. The same general symptoms appear with characteristic 
modifications. Restlessness, bellowing, pawing, inappetence, 
arched, tender loins, swollen vulva with discharge, shiny and 
perhaps fcetid but without contractions, abdomen pendent and 
flanks hollow and tender, udder lurgid, hot and painful, move- 
ments of the hind limbs stiff, halting, straddling. There is 
greater tendency to salacious movements of the croup. The 
diagnostic feature is palpation of the ovary through the rectum. 

In chronic cases more or less of the above symptoms are shown 
in a greatly mitigated form, but oftentimes there are long inter- 
vals of apparent health. Palpation through the rectum is the 
final test in this as in the more acute cases. 



Ovarian Cysts, 289 

Prognosis, This is very uncertain. Unless complete recovery 
takes place in a few weeks, the inevitable consequence is sterility, 
or death from haemorrhage, peritonitis, pyaemia, marasmus. 

Treatment, In acute cases Trasbot strongly urges bleeding in 
the larger races and leeching of the flanks in the smaller. Mus- 
tard plasters to the loins and abdomen, and cold or damp appli- 
cations to the croup are in order. Vaginal and rectal injections 
of mucilaginous liquids, containing anodynes and antiseptics are 
indicated. Opium, belladonna, hyoscyamus, chloral, borax, ace- 
tate of aluminium may serve as examples. If needful to quiet 
the excitement, morphia, atropia or hyoscyamin may be given 
subcutem. Or the anodynes may be administered by the mouth. 
As a last resort, and by far the most radical treatment, castration 
may be performed. With small ovaries this is best done through 
the vagina in the larger animals, while with large and adherent 
ones the flank operation is imperative. If the peritoneum is in- 
volved, careful antisepsis of the cavity is desirable. In case of 
adhesions the operation may be risky, but if successful it will 
obviate secondary infections and establish a permanent cure. 
Complications must be treated according to their nature. 



OVARIAN CYSTS. 



Mare, cow, ewe, sow, bitch, hen. Forms Histogenesis. Dilated vesicles, 
egg tubes, blood obstruction. Lesions : Ovary large, smooth, lobulated, 
vascular, size, connective tissue, epithelium, liquid contents. Abscess. 
Symptoms : impaired portal circulation, muco- enteritis, piles, intestinal 
torpor, impaction, constriction, obstruction, congestions, inflammation. 
Urinary disorder. Strangulation. Sterility. Abortion. Dystokia. Indigestion. 
Anorexia. Colic. Genital erethism. Straining. Altered Urine. Peritonitis. 
Septic infection. Collapse. Rectal palpation, enlarged, sensitive ovary. 
Treatment : Castration. Tapping cyst. Rupturing cyst by compression. 

These have been met with in all races of domestic animals, 
mare, cow, ewe, sow, bitch and hen. They vary greatly in 
their characters, being unilocular, multilocular, rounded or 
lobulated, serous, albuminous, colloid, or haemorrhagic, strictly 
ovarian or parovarian (in broad ligaments), in one ovary or in 
both. 

19 



290 Veterinary Medicine, 

Histogenesis, The source of these cysts has been much debated. 
Many have held with Spencer Wells that they have their origin 
in dilated Graafian vesicles, and the discovery of an ovum in 
the contents, by Rokitansky and Ritchie showed at least that 
this follicle had formed part of the cyst. On the other hand 
Foster, Rivolta, Klebs, Malassez and others, constantly failed 
to find ova or other distinct elements of the Graafian follicles, 
but did not find epithelial elements, and note that the cysts are at 
an early stage connected with the surface of the ovary like the 
egg tubes. These embryonic tubules of Pflueger are therefore 
held to be the starting point for the cysts, which because of their 
mixed epithelial as well as liquid contents, seem allied to adenoma. 
From observations on the ovarian cysts of the lower animals 
Galtier, attaches great importance to vascular obstructions. Ob- 
struction by pressure or otherwise led to haemorrhages and 
transudation of blood, and the cavities formed in this way be- 
came the seats of epithelial growth, and liquid effusion. The 
blood remained for a time as distinct clots, and was later indi- 
cated by the pigmentation of the walls of the cyst. 

Lesions, The enlarged ovary may be uniformly rounded and 
smooth, or it may be marked by irregular bosses, giving it a 
lobulated appearance. It is very vascular, and is often covered 
by a thickening of peritoneum. When multiple they are usually 
closely adherent and may even be included one within another. 
The individual cysts may be of the most varied sizes. The cystic 
ovary has at times reached enormous dimensions : in the mare 46 
lbs. (Bouley, Rivolta, Thiernesse) : in the cow 250 lbs. (Rey- 
nolds, Meyer): in the ewe 7 lbs. (Willis): in the sow 7 Ibo. 
(Reyer) : in the bitch 15 lbs. (Bovett). The walls of the cyst are 
formed of connective tissue more or less perfectly organized, ar- 
ranged it may be in several superposed layers (Galtier) and lined 
or not by epithelial cells (cylindroid, nucleated, or of various 
forms). They may be reddened by haemorrhages or pigmented 
from former blood extravasations. The liquid contents may be 
clear and watery, white, straw yellow, or of a deeper yellow, 
brown or red. Among other constituents there are alkaline 
chlorides and sulphates, albumen in solution or fiakes, mucin, 
fibrine, fatty granules and cholesteriue cystals. In some instances 
they contain pus cells (chronic abscess). 



Ovarian Cysts, 291 

Symptoms. Small, tardily growing cysts may cause no ap- 
preciable symptoms. The larger ones or those that increase 
rapidly are liable to cause disorders of circulation, innervation 
and digestion. The mere pressure of a considerable cystic ovary 
may interfere with portal circulation so as to entail muco-enteri- 
tis, rectal congestion, piles, or intestinal torpor or impaction. 
Adhesions of the diseased ovary to adjacent intestinal viscera, 
tend to produce constrictions, obstructions and local congestions 
or inflammation. In adhesions to the womb or bladder, ureter 
or kidney, the symptoms will indicate disorder of these respective 
parts. The weight of the enlarged ovary causing extension of 
its ligamentous connections will allow of its winding around a 
loop of intestine and producing strangulation. In those unusual 
cases in which pregnancy occurs it may interfere with its com- 
pletion, causing abortion or, failing in this, with parturition, 
by becoming imbedded in the pelvis. In the line of innervation, 
disorder is especially common in the digestive organs, anorexia, 
nausea, impaired rumination, and colicy pains resulting. Again, 
in many subjects the genesic instinct is stimulated, the patient is 
more or less constantly in heat, cows become bullerSy and mares 
switchers, they cannot be impregnated, and under the continuous 
excitement undergo rapid emaciation. There is often urinary 
disturbance, frequent straining with the passage of a small quan- 
tity only of turbid or glairy liquid, colored, it may be, by blood, 
or foetid. The colics are liable to be dull and slight, the patient 
moving uneasily, switching the tail, moving the weight from one 
hind foot to the other, pawing, looking at the flank, but sel- 
dom lying down or rolling. In other cases, with adhesions, 
impactions, obstructions, and congestions, all the violent motions 
of the most intense spasmodic colic may be shown. Where there 
has been rupture of the obstructed bowel, these symptoms may 
merge into those of peritonitis, septic infection, or collapse. When 
with these symptoms of intestinal disorder, there are tender loins 
and flank, abdominal plenitude and tension, genital excitement, 
frequent straining to pass urine, the discharge of a glairy or foetid 
liquid, and when all these symptoms have increased slowly for 
weeks or months in a female, the ovaries may be suspected and a 
rectal examination should be made. Usually the outline of the 
womb can be made out with the enlarged and irregularly shaped 



292 Veterinary Medicine, 

ovary anteriorly and adherent to it through one of the broad lig- 
aments ; it may be sensitive to touch, tense, or even fluctuating. 
Difficulty may be encountered when the enlarged ovary is so 
great as to fill the whole region, or when adherent to or wound 
round the rectum, thus hindering the advance of the hand or the 
movement of the gut, or when it has become pediculated and dis- 
placed to a distant part of the abdomen. Even the obstructed 
and distended intestine, may prevent a satisfactory diagnosis. 
Yet in the great majority of cases rectal examination gives con- 
clusive results. 

Treatment, Medicinal measures are useless : surgical alone 
are of any avail. Castration is the natural resort, and in all re- 
cent cases, uncomplicated by adhesions, is to be preferred. In 
the large females it may often be performed through the vagina, 
but if the ovary is very large the flank operation becomes imper- 
ative. Sometimes the evacuation through a cannula of the con- 
tents of one or more large cysts will so reduce the mass as to 
allow of the safer vaginal operation. 

A less radical measure is the evacuation of the cyst with can- 
nula and trochar and the injection of tincture of iodine. With a 
hand in the rectum the ovary may be held against the abdominal 
^vall to facilitate the operation. The results, however, are not 
satisfactory, for, although re-accumulation of the liquid is delayed, 
it is not entirely prevented . Moreover, when the cysts are multiple, 
the punctures also must be numerous, or remain ineffective. 
Nor is the operation unattended by danger as deaths often occur 
from resulting inflammation, infection, or iodine poisoning. 

Zannger, in i860, introduced the method of rupturing the 
cyst without incision, and met with considerable success. With 
the hand in the rectum the cystic ovary is pressed against the 
wall of the pelvis or abdomen, until the attenuated wall of the 
cyst gives way, the fluid is left in the abdominal cavity, to be ab- 
sorbed and many animals will afterward become pregnant. In a 
large proportion of cases in which the symptoms are marked, 
the walls of the cyst are sufficiently attenuated to allow of rup- 
ture by pressure, and, if the escaping contents are free from in- 
fecting microbes, no immediate harm comes to the peritoneum. 
It should be avoided in case of abscess, following perhaps on 
a shivering fit and constitutional febrile reaction, and when there 



Dermoid Cysts of the Ovary, Pilous Cysts. 293 

is a foetid discharge from the vulva, suggesting tnicrobian infec- 
tion likely to dangerously infect the serosa. In appropriate 
cases it is a resort of very great value, in restoring to use ani- 
mals that are especially valuable for their progeny and which be- 
come utterly useless when rendered barren. According to different 
observers an average of 70 per cent, 'can be restored to usefulness 
in this way. Friedberger and Frohner claim 90 per cent. Some 
febrile reaction may be noted for twenty- four hours demanding 
rest, restricted, cooling, laxative food and sometimes laxatives 
and anodynes. 



DERMOID CYSTS OF THE OVARY. PILOUS CYSTS. 

Closed cutaneous sacs, with hair and sebum. Causes : enclosure of der- 
moid tissue in embryo : aborted ovum : virgin gestation. Symptoms. 
Treatment : Castration. 

These are much less common than are simple cysts. They are 
closed sacs, lined by a tissue essentially representing skin, and 
containing sebaceous matter and hairs, some growing from the 
dermoid surface, and others detached and formed into a loose 
mass. 

Causes, These cysts have been* attributed to the enclosure, in 
the forming embryo, of the formative elements of dermoid tissue, 
which may or may not remain latent and inactive until maturity, 
or until the ovary becomes physiologically active. 

Another theory is that an impregnated ovum has remained im- 
perfect, developing only the elements of the skin, instead of the 
whole foetal body. Many cases cannot by any possibility be in- 
cluded under this head, seeing that the cyst is found at much too 
early an age, and its bearer has never had sexual intercourse. 

Another doctrine is that the dermoid cyst is derived from the nor- 
mal plastic or formative powers of the ovary, and the product be- 
comes suggestive of parthenogenesis or virgin gestation. The fact 
that these cysts are not confined to the production of skin and hair, 
but at times form bone, teeth, nervous and other tissues as well, 
corroborates this view. On the other hand we must bear in mind 
that dermoid cysts are much more common in other tissues than 



294 Veterinary Medicine. 

they are in thfe ovaries. Thus they are common in the sub- 
cutaneous connective tissue and between the muscles. 

The symptoms do not differ essentially from those of simple 
cysts and treatment is mainly by castration. As the escape of the 
contents into the peritoneal cavity is especially provocative of in- 
fection, the greatest care must be taken to extract the mass whole, 
or to use the most thorough antiseptic precautions. 



SOLID OVARIAN TUMORS. 

These are much more rare than cystic tumors. They seldom 
maintain the character of perfect solidity, for whether fibrous, 
sarcomatous, melanotic, cretaceous, myomatous, cancerous, 
epithelial, tubercular, glanderous, or actinomycotic, they are 
usually associated with the* cysts to a greater or less extent. Not 
only are they liable to stimulate the formation of cysts, but the 
special heteroplasia may become engrafted on the walls of pre- 
existing cysts, as well as on normal tissues. 

The symptoms of the solid tumors are in the main, those of the 
cystic form, and treatment resolves itself into extirpation by 
castration. Its success will vary according to the nature of the 
tumor, sarcoma, melanoma and carcinoma being especially liable 
to recur in the same or in distant situations, and the same is 
true of the colonizing with infectious germs (glanders, tuber- 
culosis, actinomycosis) which are presumably already present 
in other parts of the body. Castration has however, this 
recommendation, it secures the removal of the entire diseased 
organ, and if the morbid process or infection is confined to that 
only, it holds out the best prospect of recovery. 



INFLAMMATION OF THE FALLOPIAN TUBES. 
SALPINGITIS. 

This condition is met with in the female mammals of all 
species and mainly as the result of an infection extending from 
diseased womb or ovary. The results are degeneration of the 



Diseases of the Oviduct in Birds. 295 

epithelium, exudation into the mucosa with thickening, stenosis 
of the tubes, the formation of cysts along the line of the 
canal, with pink or straw colored contents, including fibrine^ 
leucocytes, epithelium and granular debris. As in oophoritis 
there may be blood extravasations and clots and abscess. In 
the cow they are at times calcified and create a suspicion of 
tuberculosis. 

The symptoms are essentially those of metritis or ovaritis, 
and as these are usually more prominent the attendant sal- 
pingitis is generally overlooked during life. Careful rectal ex- 
amination may detect the enlarged, tender or sacculated tubes. 
Treatment may be laxative, diuretic, derivative, and antiseptic 
toward the womb. Ablation of the ovaries, tubes and even the 
womb is often required. 



DISEASES OF THE OVIDUCT IN BIRDS. 

Imperforate tube near cloaca. Polypus : snare and twist off. Egg im- 
paction: from atony, inflammation, stricture, congenital smallness, ex- 
haustion, large eggs, thick end first, broken egg. Symptoms : mopes 
alone, feathers erect, wing and tail drooping, large, solid swelling around 
anus and abdomen. Rupture into abdomen. Treatment : oil cloaca and 
oviduct, manipulate, turn, break egg and scoop out, incise and extract, 
antiseptic oils. Excision of ovary. 

Imperforate oviduct usually occurs in the lower part of its 
course, the tube being connected with the cloaca by a short, 
fibrous cord. In the case of a very valuable bird it may be in- 
cised and the walls of the duct may be brought down and fixed 
to those of the cloaca. 

Polypi of the oviduct may seriously impede laying, and start ob- 
struction and impaction. The seat of the tumor having been as- 
certained, it may be seized and twisted off by a snare. An 
elastic wire is passed through a small metallic tube so that a loop 
protrudes large enough to pass over the poljrpus. When fixed 
around the pedicle, it is tightened, and the tissues twisted through. 

Egg Impaction in the Oviduct. Prom weakness or lack 
of tone in the bird, by inflammation and loss of contractile power 
in the oviduct, by stricture of the duct as a sequel of inflamma- 



296 Veterinary Medicine, 

tion or abrasion, by congenital narrowing, by weakening of the 
oviduct through constant laying, by excessive size of the ^%%y by 
double yolked eggs, by presentation of a large ^%% with its thick end 
first, or by an egg with broken shell, the oviduct may be rendered 
incapable of passing the egg on and out, and as others continue 
to press down from above an excessive and dangerous impaction 
ensues. The bird refuses food, mopes around with ruffled feathers 
and drooping head, wings and tail. The region of the anus and 
in front of it hangs downward and feels firm and solid, and the 
oiled finger introduced into the cloaca comes in contact with the 
impacted mass. The bird strains violently but ineffectually and 
rubs its anus on the ground. The swelling goes on steadily and 
rapidly increasing, and the bird becomes more prostrate and hope- 
less. Sometimes the overdistended and congested oviduct gives 
way and the eggs escape into the abdomen. Reul has counted as 
many as 24 eggs that had thus escaped into the abdominal cavity. 
Or without rupture of the oviduct, the soft eggs pack together 
into a solid, dry, yolk-like mass, the watery parts having been 
pressed out or absorbed. In bad cases this may weigh i)^ lb. in 
the hen (Weber) . In the way of treatment the cloaca and oviduct 
should be thoroughly lubricated with a bland oil, which might be 
injected with a syringe, so as to pass it, if possible, around the 
impacted egg or mass. By careful manipulation the egg may now 
be brought away. If the thick end is presented it is sometimes 
possible to turn it so that the thin end will come first. Should 
all fail the egg may be broken and its contents together with the 
other impacted matter may be dislodged with a looped wire or 
small spoon. The oviduct should be lubricated for some time 
with a bland antiseptic oil (olive oil and boric or salicylic acid). 
In obstinate cases the abdomen and oviduct may be laid open and 
both evacuated of any egg matter that may be present. After 
suitable antisepsis the wounds in the oviduct and abdominal walls 
are to be sutured. If there appears to he danger of the further 
early descent of eggs into the weakened oviduct the ovary may 
be removed. 

Eversion of the Oviduct, This appears at times as a result of 
the intromission of the penis (ducks) being shown immediately 
after copulation as a pink, lax membrane one or more inches long, 
dragging from the anus. In other cases it appears to result from 



Diseases of the Oviduct in Birds. 297 

the paresis that occurs in old birds from prolonged laying, or 
from inflammation and impactions. It may appear abruptly or 
gradually, and after a few hours becomes the seat of exudation, 
swelling and redness, forming a pyriform mass. In some cases 
it is carried out around an egg which does not glide through its 
canal and may be felt through its walls, and through its terminal 
opening. A partial eversion may take place as an invagination into 
the cloaca, without showing externally. When an egg is im- 
pacted, or when the protruded organ is inflamed and swollen, 
violent straining continues, which tends to aggravate the con- 
dition, and the bird gets rapidly exhausted, resting on its breast, 
later upon its back, and dying in convulsions. 

In slight cases following copulation, the vermicular movement 
of the duct, of the cloaca and anus may serve to secure speedy 
spontaneous reduction. In the partial cases, of eversion into the 
cloaca, the free local use of oil, may secure the passage of the 
presenting egg and the return of the oviduct. If necessary the 
egg may be broken and its shell thoroughly extracted. This last 
method is imperative when the egg enclosed in the oviduct has 
already passed through the anus. The ovidu(:t should then be 
cleansed in tepid water, and laudanum, oiled and returned. 

Inflammation of the oviduct is a common condition resulting 
from debility, from impaction of an egg or of egg-material, from 
scratching with the shell of a broken egg, and from microbian 
invasion. The frequent passage of large eggs is an accessory 
cause, and the egg becomes an important factor in the mainte- 
nance and aggravation of the inflammation. The mucosa be- 
comes red, dry, infiltrated, thickened and friable, and the muscu- 
lar coat increasingly paretic. The egg, becoming impacted, and 
subjected to constant pressure in the vain efforts at expulsion, 
hinders circulation and nutrition, and favors necrotic and ulcera- 
tive processes, and too often the fragile membranous walls yield, 
and the mass drops into the abdominal cavity. Short of this, 
the exudate at a particular point, the main seat of inflammation, 
contracting in undergoing organization, forms a distinct stricture, 
which renders the further la5dng of fully formed eggs difficult or 
impossible, and further impaction, inflammation and rupture may 
follow. Sometimes the irritation causes undue peristalsis in the 
anterior and less actively inflamed part of the tube, apd the eggs 



298 Veterinary Medicine, 

are laid prematurely without albumen or without shell, yet with 
much effort and suffering. Or the bowels become irritable and 
a profuse diarrhoea sets in, hastening the exhaustion of the 
patient. 

Treatment should be applied early. A cooling diet of vege- 
tables or slops, the careful removal of all irritating contents 
from the oviduct, and its frequent injection with bland oils medi- 
cated with mild anti-septics (boric or salicylic acid, or potassium 
permanganate) will usually serve a good purpose. 



HYDROMETRA AND PYOMETRA. 

Cause : chronic metritis, tumorp, mtcrobian infection. Symptoms : ill- 
health, low condition, vulvar swelling or discharge, swelling and flnctuation 
of womb. Rectal exploration. Treatment : evacuate liquid, disinfect 
womb an«1 passages. creoHn, iodine. 

As a rule these conditions belong to obstetrics and would not 
come under the scope of this volume, but when in chronic cases, 
with closure of the neck of the womb, the liquids accumulate and 
distend the uterus, they may deserve mention in a medical 
work. 

. The cause is usually a chronic metritis, originating it may be at 
the time of a now distant parturition, or associated with tumors 
or microbian invasions of the womb. In the deadly cases that 
follow upon parturition and abortion streptococcus is usually 
present, in the more chronic forms the staphylococcus or other 
pus microbe. 

The symptoms are those of general ill-health, low condition, 
pallor of the visible mucosae, sometimes swelling of the vtdva 
with discharge, serous or purulent, lessened milk yield, enlarge- 
ment of the abdomen with fluctuation felt in the right flank, or 
still better with the hand in the rectum. Rectal exploration will 
further detect the distended uterus connected with the vagina 
behind and dividing in front into two horns. 

Treatment consists in the evacuation of the liquid through a 
catheter or cannula introduced through the os, or through the 
vaginal wall immediately above, followed by a systematic disin- 



Uterine Tumors. 299 

• 

fection. By placing the patient upon her back, gravitation of the 
liquid is more marked, but when this is not convenient it may be 
done with the animal standing. The flow may be favored by 
raising the abdomen with a sheet held by two assistants. The 
womb may be thoroughly cleansed by a normal salt solution 
which has been boiled, and then daily injected with a creolin 
solution (i : 100). In hydrometra an iodine lotion may be used, 
A course of tonics is often indicated. 



UTERINE TUMORS. 

These are somewhat rare in the domestic animals, yet they have 
been met with in the form of cysts, fibroma, fibro-myoma, sar- 
coma, and carcinoma. In a number of cases the nature of the 
tumor has not been clearly made out. Mangot saw a mare with 
two pediculated uterine tumors having an aggregate weight of 
12 lbs. These were expelled with much straining and suffering. 
LaMaitre and Rodet record other cases. Stockfleth describes 
multiple pediculated fibroid tumors in the womb of the cow. 
Cysts have been especially seen in the cow and bitch, and car- 
cinoma in the bitch. 

Symptoms. These may for a length of time be overlooked, though 
breeding animals usually fail to conceive. Then a slimy, muco- 
purulent, serous, bloody or foetid discharge may escape habitually 
from the vulva, smearing the tail and hips and collecting on the 
floor. If the os is sufficiently patent to admit the hand vaginal 
and uterine exploration will detect the tumor. In other cases it 
may be felt by rectal examination. 

Treatment is essentially surgical and will consist in dilatation 
of the OS, and the removal of the tumor by twisting, ecraseur, or 
curette, and with careful antiseptic precautions before and after. 
In malignant tumors in the uterine walls it may be expedient to 
remove the entire organ. 



UTERINE TUBERCLE. 

This has been seen especially in sterile cows, the subjects of 
nymphomania, and it may be associated with a muco-purulent or 
bloody discharge from the vulva, nodular swelling on the uterine 
horns, perhaps also on the broad ligaments, one or both ovaries, 
and the mesentery, to be recognized by rectal examination. The 
presence of tuberculosis in the lungs or throat, and the response 
to the tuberculin test will confirm the diagnosis. As a rule it is 
not desirable to institute treatment. 



IMPERFORATE HYMEN. 

Cases of this kind have been described in mare and cow, pre- 
venting copulation and conception, and leading to a distension of 
the vagina, with a glairy fluid, which obstructed defecation, 
irritated the bladder and caused violent but fruitless straining, 
under which the mass would project from the vulva. The centre 
of the swelling may be penetrated with a trochar or bistuory and 
enlarged by incisions in several directions. Relief is prompt and 
lasting. 

VAGINITIS. LEUCORRHCEA. ' 

Inflammation of the vaginal mucosa is usually a concomitant 
of metritis and like that follows parturition. It will however oc- 
cur independently from direct injury or infection or from the 
presence of neoplasms. In dourine and horse-pox, vaginitis is a 
common symptom ; to mare, cow and bitch infection is conveyed 
by coition. Dieckerhoff quotes old chronic cases, also acute ones 
which extended to the peritoneum and proved fatal in a few 
days. The common symptom of muco-purulent discharge having 
a heavy or foetid odor is together with the discharge from the 
womb known by the common name of leucorrhoea. The frequent 
irrigation of the whole passage with antiseptic solutions is usually 
successful in putting a stop to the affection, unless in case of con- 
stitutional infection, or the presence of some neoplasm. 
300 



TUMORS OF THE VAGINA. 

The vagina is the seat of different forms of neoplasms in the 
various domestic animals.* Thus cystoma, lipoma, adenoma, 
fibroma, fibro- myoma, sarcoma and epithelioma have been noted. 
They are essentially surgical and to be dealt with as such. They 
are mainly important in thfs connection as inducing a leucorrhcea, 
which in the absence of careful examination might be mistaken 
for that of uterine or vaginal infective inflammation. 



PARTURITION FEVER (COLLAPSE). MILK FEVER. 

PARTURIENT APOPLEXY. CALVING FEVER. 

PARTURITION PARESIS. 

Definition. Predisposing causes : genus, breed, great milking capacity, 
heredity, mature age, vigor, high- feeding, powerful digestion and assimila- 
tion, sudden plethora, drying up of milk, parturition, easy delivery, warm 
season, chills, idiosyncrasy, cardiac hypertrophy, contraction of womb, 
emotional excitement : Supposed causes : absorption of toxins from womb, 
colostrum, Schmidt treatment its significance, microbian infection and in- 
toxication, effect of change of stable. Microbiology. Nature : Theories of 
nervous explosion, vaso-motor cerebral anaemia from exaggerated excita- 
bility of the uterine nerves, or from dilatation of the portal system and 
womb, metro peritonitis, cerebral anaemia from congestion of the rete 
mirabile, etc., palsy of the ganglionic nerves, plethora, intra cranial arterial 
tension, narcotic poisons from leucocytic or microbian source. Lesions : 
variable, cerebral and spinal congestion, pulmonary congestion, collapse, 
septic inhalation, bronchitis, dessication of ingesta in omasum and large 
intestine, black thick blood, yellowish gelatiiioid exudates in cranium and 
spinal canal and under spine, glycosuria. Symptoms : time, post partur- 
ient, plethoric subject, sudden onset, comatose and violent forms, discom- 
fort, restless movements, inappetence, moaning, mental dullness, unsteady 
walk, muscular weakness, compulsory recumbency, retained urine and 
faeces, drowsiness, somnolence, unconsciousness, stertor, venous pulse, 
tympany, sudden recovery, complete, with paralysis, fatal cases, violence, 
tossing head, trembling, cramps, convulsions, temperature. Mortality. 
Prevention : bleeding in plethoric, heavy milkers, purging, low diet, exer- 
cise, comfort, milking, blisters, sucking by calf, disinfection, iodine solution 
301 



302 Veterinary Medicine. 

in udder. Treatment : in early stages bleeding, purgatives, peristalsis 
stimulants, antiseptics, injections, stimulants, rubefacients or cold sponging, 
elevation of the head, udder massage, milking, iodine injection of the 
mammae with iodine or creolin or salt solution, oxygen or sterile air. 

Definition. A nervous disorder which develops suddenly in 
plethoric cows, heavy milkers, after calving, and is characterized 
by loss of sense, of consciousness and of muscular control, by 
hypothermia or hyperthermia, convulsions, coma, and mellituria. 

Causes. While one cannot speak positively as to the essential 
cause of this disease, certain conditions are so constant and 
prominent that they must be given a high value ?iS pre- disposing 
causes. 

Genus and Breed. Milking Capacity. This is essentially a 
disease of cows, probably largely because of all domestic animals, 
cows only have been long and systematically bred to secure the 
greatest power of digestion and assimilation and the highest yield 
of milk. It is the disease not* only of cows, but of milking 
breeds, and preeminently of individuals that give the most abun- 
dant dairy product. It is rare or unknown in scrub or common 
herds, while common and fatal in the best milking breeds, in ad- 
vancing ratio about as follows : short horn, red polled, Normand, 
Swiss, Ayrshire, Flemish, Dutch, Aldemey, Jersey, Guernsey, 
and Holstein. Heredity may be claimed, as the special pre-dis- 
posing qualities are hereditary. 

Age has a marked influence, but this is subsidiary to the milk- 
ing qualities. The disease rarely attacks a cow after the first or 
second calving when the system is as yet immature, and the milk 
yield has not reached its maximum : nor one that is past its 
prime and already failing in vital energy and milking qualities. 
The following table is from statistics complied from veterinary 
records in Denmark and Bavaria : 



Age.yrs— 3 


456789 


10 


II 


12 


13 and over. 


Cases 8 


21 65 160 171 202 117 


124 


44 


70 


78 



It will be noted that it is in the period of the most vigorous, 
mature life, from the 6th to the loth year inclusive that the great 
majority suffer. In a judiciously managed dairy it is the best 
cows that are carried at these ages, and although the very best 
are kept on into old age they show a steadily decreasing number 
of cases as they begin to fail. The disease is all but unknown 
in primipara. 



Parturition Fever, Etc, 303 

High Feeding. Heavy and rich feeding prior to calving and 
immediately after, is a most prominent cause of the affection. 
This is so well known to owners of milking breeds, that they 
usually hold to the principle that the cow that is a heavy milker, 
should be all but starved for a fortnight before calving and for a 
week after. In herds where this rule is acted on the disease is 
rare and may be altogether unknown, and when it is neglected the 
malady is often very destructive. 

Plethora, High Condition. Heavy feeding and high condi- 
tion usually go together, and the majority of the victims are fat or 
in good flesh, yet a certain number are actually thin. The 
predisposing condition is plethora rather than fat or flesh, and 
this may be present in the comparative absence of flesh. The 
cow that is from a stock famed as heavy milkers, does not tend to 
lay on flesh, but, on succulent diet especially, the greater part of 
the nutritive matter assimilated goes to the production of milk, 
and she remains thin in flesh no matter how heavily she may be 
fed. Many such cows never go dry, but give a liberal yield of 
milk up to the day of calving, and if measures are taken to dry 
them up, it is done at the expense of a sudden plethora, as the 
milk giving system does not at once accommodate itself to the 
la>nng up of fat and flesh. 

The drying up of the milk secretion sometime before calving in 
a cow which is normally a heavy milker is therefore a potent factor. 

Parturition is an almost indispensable factor as the disease oc- 
curs one to seven days after that act, and only in rare and some- 
what doubtful cases before it. 

Easy Delivery with little nervous outlay or loss of blood, and 
no exhaustion is a special feature. The attack almost nevfer oc- 
curs after a difficult parturition with considerable loss of blood 
and much nervous exhaustion. This should to a large extent 
exclude such alleged factors as shock or wearing out of nervous 
energy. The nervous prostration which figures so prominently 
in the disease, seems to be less the result of wear and tear, than 
of the supply of an excess of blood, which is either over- 
enriched, or charged with some injurious toxic matter. At the 
same time there is a manifest susceptibility at the parturient 
period which is not present at other times, and the plethora or 
toxin takes occasion to operate when this predisposition renders 



304 Veterinary Medicine, 

such an attack possible. The Warm Summer Season has been 
claimed to induce a greater number of cases, and doubtless ex- 
posure to continuous heat, tends to prostrate the nervous system 
and predispose to congestion, this fails to take into account the 
still more important element of the rich spring and early sum- 
mer pastures; where the already plethoric animal is left to feed 
without stint, or the tempting red clover, alfalfa and other fodder 
crops, rich in albuminoids, which are fed liberally in a succulent 
condition. 

Chills in cold winter weather have been similarly invoked as 
driving the blood from the surface to collect in internal organs, 
including the brain. That chills do act in this way cannot be 
denied, but there is no demonstration that any number of cases 
have been materially affected by cold. 

Idiosyncrasy, Co^istitutional Predisposition, This must be al- 
lowed, inasmuch as that it covers all those individual conditions, 
functional and structural, which belong to the heavy milker, or 
the animal with extraordinary powers of digestion and assimila- 
tion. The same shows in the predisposition to a second attack 
of an animal which has survived a first one. The structural 
changes in the nerve centres, which occur in the primary attack, 
leave traces, which render these parts more susceptible at the 
next calving. In my own experience the violence of the disease 
is liable to increase with successive attacks, so that a second or 
third cannot be hoped to be as mild as was the former one. 

Cardiac Hypertrophy, Cagny draws attention to the fact that 
in man and beast alike the heart undergoes hypertrophy during 
gestation and, above all, during the later stages. In improved 
breeds of cattle, and especially in milking breeds, a great de- 
velopment of the whole circulatory system is seen, and a large 
heart is a constant feature of this. This implies an increased 
force of cardiac systole, an increased blood tension in the arteries 
and capillaries, a condition which tells with special force on the 
soft tissues of the brain, as the violent abdominal compression in 
the expulsive efforts of parturition, tends to drive the blood from 
the great vascular viscera situated back of the diaphragm. 

Parturition and the subsequent contraction of the womb and ex- 
pulsion of the great mass of blood, must be accorded a prominent 
place among causative factors. The disease is almost restricted 



Parturition Fever ^ Etc, , 305 

to the first week after parturition, and its gravity is greater the 
more nearly it is related to the parturient act. Cases occurring in 
the first three days are usually fatal. The gravid uterus contains 
a very large amount of circulating blood, and when the womb con- 
tracts, the greater part of this is suddenly thrown upon the general 
circulation, already plethoric to an undue extent. As yet the 
mammae are congested and there is no free depletion through 
that channel, so that there is a marked temporary plethora and 
vascular tension, before the system can establish free elimination 
and, as it were, strike a healthy balance. In this period of tran- 
sient plethora there lies a source of great danger to the general 
system and, more particularly, to the brain. 

Emotional Excitement connected with the removal of the calf 
is urged by Giinther, Jaumain, F61izet and others as a prominent 
cause. This, however, must be rare, at the most ; the disease 
does not attack the primipara that should be most susceptible to 
this influence, but the mature animal, at her third calving or 
later when she is already well accustomed to this treatment ; it 
supervenes so quickly on parturition in many cases, that there 
was no opportunity for such emotion ; it occurs also in cows, the 
calves of which have remained with them or have received no at- 
tention from them. 

Absorption of Leucornaines from the Udder. At parturition the 
trophic and secretory activity of the udder of the heavy milking, 
plethoric cow is phenomenal, and with this extraordinary and 
sudden rise in the circulation, and in cell growth and work there 
is a corresponding increase in the leucomaiiies or toxic alkaloids 
of the cells. If those alkaloids are promptly introduced in large 
quantity into the general circulation, the highly susceptible 
nerve centres at once succumb to the poison. This theory agrees 
perfectly with the therapeutic developments of the last few years. 
The Schmidt treatment, by injecting the teats with a quart of 
water holding 100 to 200 grains of iodide of potassium in solution, 
reduced the mortality from the disease from 70 per cent to 15 per 
cent. Injections of other antiseptic solutions proved equally effec- 
tive. So did a simple normal salt solution. Overfilling of the 
udder with milk by putting off the first milking for 24 hours 
after calving virtually put a stop to cases of the disease. The 
filling of each teat and quarter of the udder to repletion with 
20 



3o6 Veterinary Medicine, 

oxygen in every case of milk fever, reduced the mortality to a 
fraction of one per cent. Finally the injection with simple 
sterilized air proved equally effective and deaths came to be con- 
sidered as extremely improbable even in very bad cases. This 
points unequivocally to the arrest of the formation of leucomaines 
by the reduction of the circulation in the udder. The extreme 
distension of the milk ducts and follicles by bland gas, or liquid, 
compresses the vessels in their walls and reduces the flow of 
blood. With this reduction of the circulation comes the arrest of 
the formation of the toxic leucomaines and of their absorption. 
When the poison no longer reaches the nerve centres in danger- 
ous quantity the nervous disorder, and collapse are prevented or 
corrected. This hypothesis explains every phenomenon apd is 
obviously the right one. 

Microbian Infection or Intoxication, This has been of late a 
favorite hypothesis, apparently sustained by the sudden and pro- 
found prostration of the nerve centres, the notorious prevalence 
of milk fever in given hamlets, and the occasional arrest of the 
disease in a herd, by moving the parturient cows to a previously 
unoccupied stable and holding them there until nine days after 
calving. But on the other hand the disease occurs in the strong 
plethoric cow, not in the impoverished one which should have 
less vital resistance ; it follows the easy unassisted parturition in 
which there has been no chance for the introduction of bacteria 
by the womb nor any shock nor exhaustion to render the system 
more susceptible, while it respects the cases of diflScult parturition 
with abundant introduction of microbes on hands and instru- 
ments ; no inoculation from the womb upon another parturient 
cow has produced the disease ; finally, if it were due to the ab- 
sorption of microbes or their toxins from the milk in the udder 
the bacteria should be increased in the abundant lacteal culture- 
medium and the absorption of the toxins more active from the 
tense and overfilled milk ducts into the relatively more flaccid 
blood vessels, whereas the simple overdistension with milk is the 
best prevention of the disease. The mere presence of cocci or 
bacilli, which are by no means constant, nor always of the 
same species in cases where they do occur, can mean nothing as 
causative factors in the face of the above facts. In short, bac- 
teridian infection of womb or udder must be eliminated from the 
list of essential causes. 



Parturition Fever, Etc. 307 

Nature of Milk Fever, As above intimated, everything points 
to the excessive production of leucomaines in the udder which 
has been called to undergo a sudden, phenomenal congestion and 
physiological activity. The other explanations, put forth at 
different times, are one and all untenable. Contamine considers 
the disease as the reaction of the surplus nerve force, which was 
not used up in the easy parturition. The theory is fantastic as 
accounting for the rapidly developing aesthenia and paralysis. 
Billings thinks the cerebral anaemia is due to vaso-constriction 
produced by the exaggerated excitability of the uterine nerves. 
Yet the most marked features of these cases is the quiescence of 
the womb. Trasbot looks on the affection as a congestion of the 
myelon apparently shutting his eyes to the far more prominent 
encephalic symptoms. Haubner considers it as a cerebral anaemia 
induced by the vaso-dilatation in the portal system and abdominal 
viscera generally, the result in its turn of the vacuity of the 
abdomen, from the expulsion of the foetus and its connections. 
But the womb is often contracted and comparatively exsanguine, 
the plethoric condition of the systemic vessels is suddenly in- 
creased by the great mass of blood from the uterine vessels which 
maintains a marked general blood tension, and finally, the closed 
box of the cranium cannot have its blood drained from it without 
some effusion to take its place. Stockfleth attributed the malady 
to a metro-peritonitis, but there is rarely any indication of such a 
condition. Frank claims a cerebral anaemia due to an over-dis- 
tension of the rete mirabile^ but sheep and goats, with more 
abundant retia mirabilia, do not suffer. Palsy of the ganglionic 
system with succeeding congestion of the myelon and encephalon 
(Barlow, Kohne, Carsten Harms) fails to explain why the effects 
are concentrated on the cephalic nerve centres. Glucosuria is 
constant in the disease in ratio with its violence, but this contin- 
ues for days after the cow has recovered and is to be looked on 
as a result of disorder of the medulla and consequent derange- 
ment of the liver and not as the cause. 

Lesions, These are exceedingly variable in successive cases. 
Congestion and effusion in the meninges, cerebral or spinal, in 
the rete mirabile and choroid plexus have been often noticed, and 
exceptionally clots of extravasated blood. In certain cases con- 
gestion and pink discoloration of portions of the brain substance 
(cerebral convolutions, bulb, ganglia) with marked puncta vas- 



3o8 Veterinary Medicine, 

culosa, are found, while in others the greater part or the whole 
of the encephalon is anaemic. The puncta in such cases, large 
and dark, on the surface of the section, promptly enlarge until 
they may form distinct drops. 

In the lungs areas of collapse, and of dark red congestion and 
infiltration are common, mostly as the result of the entrance 
of alimentary or medicinal matters into the bronchia owing to 
palsy of the pharynx. Such materials can be found in the 
bronchial tubes. 

The third stomach and the large intestine may be impacted, 
the contents more or less baked and glossy on the surface, and 
coincident congestions of the mucosa are not uncommon. In 
some instances, however, the contents are soft and pultaceous 
and the absence of mucous congestions is remarkable. 

The womb rarely shows characters diflFering from the condition 
which is normal to the first few days after parturition. 

The blackness and thickness of the blood has been noted by prac- 
tically all observers. This is partly the result of its density, but 
doubtless also of the undetermined toxins which are operative 
in the disease. 

Yellowish gelatinoid exudates have been found in the subdorsal 
and sublumbar regions, as well as the cranium and spinal canal. 

Glucose appears to be constantly present in the urine, and in 
excess in the more violent and fatal cases : from 1.19 grm. per 
litre in slight cases to 41.8 grms. in a fatal one (Nocard). Al- 
bumen may be present, though probably only when local inflam- 
mation has supervened. 

Symptoms, The conditions of the attack should be noted. 
This is a disease of the first six days after parturition, rarely 
seen in the second week, and never after the fourteenth day. It is 
very exceptional before parturition, yet Miiller quotes 47 cases in 
1 107 births. The breed, condition, milking qualities, plethora, 
feeding, etc., of the patient are, as already noted important data 
in diagnosis. The onset is sudden without premonitory symptoms. 

Two very distinct types are met with, the comatose and vio- 
lent or spasmodic, which, however, merge into each other by 
insensible gradations, and may follow each other. 

From twelve to seventy hours after an easy parturition there 
suddenly appear signs of discomfort. Feeding and rumination 



Parturition Fever^ Etc, 309 

cease, the calf is neglected, there may be plaintive moaning, the 
eyes seem dull and clouded, the eyelids drooped, the conjunctiva 
red, the pulse normal for parturition, sometimes extra strong, the 
breathing excited often with moans or grunts. The senses are 
dulled, the walk is unsteady, the feet being abducted and planted 
like clumps, or the legs sway, perhaps cross each other, remain 
semi-bent, and soon give way leaving the animal prostrate, rest- 
ing on the sternum and abdomen, or later on the ribs, with head 
extended. Attempts may still be made to rise, but this is rarely 
accomplished unless when improvement sets in. This is the con- 
dition in which the patient is usually found, being the first to 
be noticed by the owner. The bowels are torpid, the urine 
retained in the bladder, and the animal may remain thus in a 
drowsy condition, without changing from the stemo-ventral de- 
cubitus, or dropping the head on the ground until improve- 
ment sets in. The head rests on the shoulder or upper flank. 
If held outward or forward the upper border of the neck has 
an S shaped outline. 

More commonly the somnolence increases, passing into a 
complete torpor, insensibility, the eye may be touched 
without causing winking, pricking or other injury causes no 
further Tesponse, the patient turns upon its side, with its head 
extended on the ground. She may lie. in this condition with 
no sign of vital activity save pulsation and breathing, and the 
latter is liable to be slow and stertorous bj' reason of the paraly- 
sis of soft palate and larynx. The jugulars usually show a 
venous pulse. Fermentations in the inactive paunch cause the 
evolution of gas with tympany, which still further obstructs the 
breathing, and reacts injuriously on the nerve centres. The 
normal eructations from the rumen may continue, with liquids 
and floating solids, and in the paralytic state of the throat these 
too often pass in part into the bronchia, causing septic bronchitis 
and pneumonia. The same is liable to follow the administration 
of liquids, the irritant drugs passing into the larynx, trachea and 
lungs. The pulse becomes soft, small and finally almost imper- 
ceptible. It may be 50, 60 and upward. 

In favorable cases, defecation may still occur, or the rectum 
once emptied may fill again through the continuance of peri- 
stalsis, the milk continues to be secreted, and in one to four days, 



3IO Veterinary Medicine, 

spontaneous defecation and micturition may be resumed, and the 
patient may get on its limbs and commence feeding. There is 
usually at first a little weakness of the limbs, but this is transient 
and health is restored in a very short time. The suddenness of 
the improvement is often as marked as of the attack. The 
patient is left prostrate and insensible, without giving any re- 
sponse when the eyeball is touched and in two or three hours it 
is found on its feet, eating, with eyes bright and clear. 

Some patients, however, are restored to ordinary sensation, in- 
telligence and appetite, while the hind limbs remain paralytic, or 
paretic, and the station and gait both weak and uncertain for 
days or even weeks. In such cases there have been presumably 
structural changes in the nerve centres, which require time for 
repair. 

In fatal cases, death may occur quietly from apoplexy, cerebral 
compression, or narcotism, or it may be preceded by a period of 
marked excitement or disorderly muscular movements. Lifting 
of the head, throwing it alternately on the shoulder and on the 
ground, trembling of head, members and body, cramps or jerk- 
ing of the limbs or of other parts, drawing the hind limbs up 
against the abdomen, and again extending them, rolling of the 
eyes, loud, noisy, irregular, embarrassed breathing andi a run- 
ning down pulse are often marked features. 

The temperature range is peculiar. At the start there may be 
some hyperthermia 103° or 104** ; with the advance of the dis- 
ease it tends to become lower, 98°, 96°, or 94°. When improve- 
ment sets in, it rises again promptly to the normal. 

Cadeac describes a special form which is ushered in by great 
restlessness, bellowing, throwing the head to right and left, 
grinding the teeth, sucking the tongue, salivation, licking of cer- 
tain parts of the body, spasms in the neck, back or limbs, and 
prompt recovery, or lapse into the comatose condition as above 
described. It proved less fatal than the ordinary comatose type, 
but seems to depend on similar conditions. 

Prognosis, Mortality, The disease is very deadly, the mor- 
tality in time past having reached 40, 50 or even 60 per cent., 
the gravity increasing as the disease set in nearer to parturition. 
Cases occurring on the first or second day were mostly fatal, 
those at the end of the first week were hopeful, and those occur- 



Parturition Fever ^ etc, 311 

ring during the second week were very hopeful. With the 
Schmidt (iodine) treatment the mortality is claimed to be reduced 
to 16 or 17 per cent., and with the air inflation treatment to .5 per 
cent. 

Prevention, Measures directed toward the lessening of 
plethora tend to remove one of the most fruitful causes of the 
disease and though not invariably successful, are yet of great 
value. The most direct is the ahstrcLction of blood in the last fort- 
night of pregnancy, to the extent of 6 or 8 quarts. This tends 
to secure a lessening of the blood tension, and blood density, but 
there is the drawback of a created tendency to a subsequent in- 
crease in the blood formation to make up the loss. This measure 
should be reserved for cows that are very plethoric, extra heavy 
milkers and such as have already suffered from the disease. 

Purgatives will measurably secure the same end without the 
same degree of danger. One to two pounds of Epsom or Glauber 
salts in the last week of gestation, or at latest when labor pains 
set in, tend not only to remove solid or impacted masses from the 
first and third stomachs, and inspissated contents from the large 
intestines, but to secure a free depletion from the portal system. 
If not before, this should always be given immediately after 
parturition to cows in extra high condition, heavy milkers, and 
that have had a short and easy delivery. 

Restriction ofjood for a week before and as long after parturi- 
tion is of equal importance. A very limited supply of aqueous, 
easily digested, and laxative food (roots, sloppy bran mashes, 
fresh grass, ensilage) will meet the demand. 

Exercise in the open air is of great value in giving tone to the 
muscles, and especially the nervous system, and in stimulating 
the enunctories and other functions. 

In the cold season protection against cold draughts and chills 
must be seen to, and in the hot season the avoidance of an excess 
of solar heat and above all of the confined impure air of the barns. 

At midsummer and later, there is often great danger in the 
rich clover and alfalfa pasture, or soiling crop, with which the cow 
will dangerously load her stomach, and the only safe course is to 
remove predisposed animals and shut them up in a bare yard or 
box-stall. Under such simple precautions herds that had formerly 
suffered severely, have had the disease virtually put a stop to. 



312 Veterinary Medicine. 

In individual cases other measures are indicated. When the 
udder has reached an enormous size and development, and is 
gorged with milk, days before parturition, it may be syste- 
matically milked. The irritation in the gorged gland is quite as 
likely to induce premature parturition, as in milking, and, at the 
worst, the result is not so bad as an attack of parturition fever. 

Basing his advice on the fact that parturition fever does not 
follow a case of severe dystokia, Cagny applies sinapisms on the 
loins, croup and thighs of a fleshy, plethoric, heavy milking, 
parturient cow. Proof of their eflficacy is not obtainable. 

Felizet advises leaving the calf with its dam for one week. 
Kohne doses the cow with nux vomica : Harms, with tartar 
emetic. 

In view of the probability of a bacterial infection the cow 
should be taken to a clean, pure, well-aired stable a day or two 
before calving, having been first cleansed from adherent filth, 
ind sponged all over with a 4 per cent, solution of carbolic acid. 

To prevent diffusion of infection Bournay recommends anti- 
septic injection of the womb immediately after calving. Bis- 
sauge adds that the stable should be disinfected after every case 
of parturition fever, the manure carefully removed and the 
ground scraped and well watered with a disinfectant. 

For fleshy, plethoric, predisposed cows, the distension with 
air or gas of the udder should be applied immediately after calv- 
ing. Or the udder should be left unmilked and gorged with its 
own secretion for twenty-four hours after calving. These meas- 
ures are incomparably more effective than all others quoted 
above. 

Treatment, With the state of plethora and congestion abotit 
the head in the early stages the question of bleeding at once arises. 
If early enough while there is a full bounding pulse, and as 
yet no sign of great loss of muscular control it is often very bene- 
ficial, as much as 6 quarts or more being withdrawn. It is well 
however to avoid cording the neck, which must increase the vas- 
cular tension in the brain, and to trust rather to digital com- 
pression of the vein. The blood should be drawn from a large 
opening in a full free stream, and may be stopped when the pulse 
softens. In the more advanced condition, with paralysis and more 
or less dulling of the senses, or coma, bleeding may be dangerous 



Parturition Fever, etc, 313 

rather than useful. There is then serious pressure on the brain, 
with serous effusion, and perhaps blood extravasation, and in any 
case anaemia, and this latter may be dangerously or even fatally 
increased by the lessening of the blood pressure, without any 
compensating advantage in 'the way of reabsorption of the effusion. 
In such cases eliminating agents are a safer resort. 

Purgatives commend themselves, but with the drawback of a 
too tardy action. Now however with the peristaltic stimulants 
given h5rpodermically this objection is largely obviated. Pilocar- 
pin lYi gr., and eserine 3 grs. will often secure a noticeable 
movement of the bowels in the course of fifteen minutes, imply- 
ing a corresponding motion onward in the bowels more anteriorly^ 
and even of the contents of the gastric cavities. If there is al- 
ready palsy of the muscles of deglutition, this may be repeated 
several times at intervals of four or five hours. If however de- 
glutition is still well performed a purgative of one or two pounds 
Epsom salts, with 10 drops croton oil, and i oz. oil of turpentine 
may be given by the mouth. Should this operate, it will supple- 
ment and carry on even more effectively the work of the hypo- 
dermic agents, and even lessen the density, plasticity and ten- 
sion of the blood and act as a potent derivative from the brain. 

A compromise may be made by giving aloes 2 ozs. , croton oil 
20 drops in bolus ; or i to 2 ozs. sulphate of soda in solution 
may be injected subcutem. 

In any case oil of turpentine or other antiseptic is of great 
value in.the stomach in preventing fermentation and tympany, 
and thereby obviating a whole series of troubles such as : cerebral 
disturbance by nervous shock and blood pressure ; impaired res- 
piration and haematosis by pressure on the diaphragm : and eruc- 
tations of food to the pharynx and its inhalation or gravitation 
into the lungs. 

It is always well to clear out the rectum by injections, when if 
there is any indication of pharyngeal paralysis most of the 
remedies may be given by this channel. 

Stimulants (ammonia carbonate, alcohol, anise, fennel, ether, 
nux, etc.) have been largely employed by the mouth and may 
be by the rectum. In the absence of spasms I have relied largely 
on nux or strychnia. 

When the skin chills, some have sought to heat it by enveloping 



314 Veterinary Medicine, 

the prosterior half of the body in cotton or wool soaked in tur- 
pentine, by applying sinapisms, or by moving over the surface .a 
warming-pan containing red hot charcoal. 

More generally cold in the shape of cold water, ice or snow has 
been applied to the cranium or spine, 'Theoretically the ansemic 
brain might be thought to forbid this, but clinically it often oper- 
ates well, possibly by inducing a sympathetic contraction of the 
vessels in and around the nerve centres and thus indirectly favor- 
ing the resumption of active circulation and the reabsorption of 
effusions. 

An elevated position of the head is no less important. It favors 
the return of blood from the brain by gravitation, and in this way 
improves the intracranial circulation, and the resumption of nor- 
mal function. A halter, or a rope around the horns, may be tied 
to a beam overhead, or the head may be laid on thick bundles of 
straw which will keep it up to or above the level of the chest, and 
in this way not only is gravitation ensured, but the brain is pro- 
tected against the violent blows and concussions, which come 
from dashing the head on the ground. 

Modem Treatment of Milk Fever. The modem treatment was 
inaugurated in 1897, when Schmidt, aiming at antisepsis, injected 
into the four teats a quart of previously boiled water holding 100 
to 200 grains of potassium iodide in solution. The mortality 
which had been as high as 70 per cent was at once reduced to 15 
per cent. Others followed with solutions of other antiseptics 
(creolin, cresol, lysol, chinosol, boric acid, phenol, and even com- 
mon salt) and had a corresponding success. The Jersey Island 
dair5mien found that by leaving the udder unmilked for 24 hours 
their predisposed cows were protected against attack. Next came 
the full repletion of the udder with oxygen gas which excelled 
all other methods, reducing the mortality to a fraction of i per 
cent. The final step was inevitable and the pumping of the udder 
full of sterilized air proved the simplest, most soothing and most 
effective of all. My first case in 1903 had been eight hours under 
the Schmidt treatment without relief from coma, but was on her 
feet exercising all her functions healthily 2}i hours after the 
sterile air treatment had been applied. She lived to prove the 
heaviest milker of that season in a large herd of extra-milking 
Holsteins. In one remarkable case the fever, the second attack 



Parturituni Fever, etc, 315 

in the same animal, came on a month before parturition, and a 
prompt recovery followed the distension treatment. Parturition 
was accomplished normally and safely more than a month later, 
no nervous prostration appearing. In the past two years thou- 
sands of cases have been treated by the distension method (with 
oxj'^gen or sterile air) with less than i per cent of losses. 

Technique. To prevent infection, the main danger, the most 
careful antiseptic or aseptic precautions are demanded. 

The injectors found on the market are generally clumsy and 
unwieldy but operate well in careful hands. In the absence of 
this an excellent substitute can be made from a common Davidson 
syringe. Having secured the elastic ball and delivery tube 
furnished with valves to direct the current of air, the delivery 
tube is cut across and the two ends connected with a small glass 
tube loosely filled with sterilized cotton. In the free end of the 
rubber delivery tube fit a silver milking tube for insertion into 
the teat. Sterilize the entire apparatus by heating in a water 
bath for five minutes, and enclose it in a sterilized towel and tin 
box until taken out for immediate use. The patient is to be pre- 
pared by thorough washing of udder and teats with soapsuds, 
rinsing off with clean boiled water at a moderate temperature, 
and finally applying to the teats a 5 per cent solution of creolin 
or lysol and supporting the gland on a sterilized towel until in- 
jected. All being ready the middle of the teat is held between 
the finger and thumb of the left and the teat-tube held by its 
attached end in the right hand is inserted in the teat, the elastic 
bulb being manipulated by an assistant until the quarter is in- 
flated like a bladder. The tube is now withdraw and the end of 
the teat is tied with a broad tape to prevent the escape of the gas. 
The tube is inserted in each of the teats in turn, with the same 
precautions, and the other three quarters are blown up in the 
same way. It is a good practice, in passing the tube from one 
teat to another, to dip the tube in strong creoline, rinse it off in 
boiled water and then it is in an aseptic condition. The cotton 
used as a filter may have a small crystal of some volatile anti- 
septic (salol, naphthol, thymol) inserted into it. This is not 
strictly necessary, yet it is an excellent placebo and serves to en- 
hance the impression of the importance of the other and more 
indispensable antiseptic measures. The recumbent cow should 



3i6 Veterinary Medicine, 

be kept on her breast bone with the head elevated even if it 
should be necessary to pack her around with straw bundles or to 
suspend the head by a halter. Lying on her side is liable to 
develop bloating, regurgitation from the paunch, and inhalation 
bronchitis, or pneumonia. 

The almost invariable result of the treatment is that in two to 
two and a half hours the cow gets on her feet, the bowels move 
freely, urine is discharged copiously, and water and food are 
taken, indicating a resumption of the normal nervous functions. 
If in two hours the patient is not on her feet, nor looking brighter 
and more intelligent, if she has passed no manure and urine, and 
if the injected air has been absorbed, leaving the udder less tense, 
the injection of the bag may be repeated under the same 
scrupulous antiseptic precautions as at first. This may be re- 
peated later if necessary. In all cases, but especially in severe 
ones, it is well to keep close watch of the cow for twenty-four 
hours, and if there is any indication of a relapse to repeat the 
treatment by udder distension. 

Complications must be met according to their nature. Bloat- 
ing may require puncture of the rumen, evacuation of the gas 
and the introduction of ammonia solution or other antiseptic. 
Inhalation of food-materials may demand antiseptic inhalants, or 
even solutions, but is very liable to prove fatal. Lesions of the 
back or limbs may require appropriate treatment. Congestions 
or infections of the udder may require active antiseptic injections 
(2 per cent solution hydrogen peroxide, iodoform, creolin ) in such 
amount as will not diminish the mammary tension. Complications 
affecting the womb, bowels, brain or other organ must be dealt 
with according to indications. 

The economic value of the new treatment is almost inestimable. 
In the past milk fever has been the bane of the best dairy herds, 
and of the best cows in such herds, of those which, if preserved, 
would have brought offspring capable of increasing the general 
yield by 50 or 100 per cent. Thus by this disease the maximum 
value was continually being cut down, the survivors, the ances- 
tors of future herds, being mainly the less valuable, the less pro- 
ductive and the less remunerative. When, however, we can 
guarantee the recovery of even the most strongly predisposed cow 
from milk fever, we preserve the phenomenal milker for a long 



- • Parturition Fever, Etc, 317 

lifetime of service, we secure from her a numerous progeny 
which under judicious management would be even better than 
herself, and we increase the yield and profit beyond the dreams 
of the dairyman. Suppose our 17,000,000 of cows should have 
their yield doubled, the resulting enhanced profit might at a very 
moderate computation be set down at $30,000,000 to $40,000,000 
per annum. This assumes that this modem gift of veterinary 
medicine should be generally availed of ; should it fail to be so, it 
will be the fault of the stockowner in neglecting the boon which 
the veterinary profession has generously placed in his hands. 



DISEASES Ot THE EYE. 

DESIRABI.E FEATURES IN THE EYE. 

The eye in the physiognomy. Broad forehead. Pull eyes. Both eyes 
alike. Iris smooth, lustrous. Media translucent. Pupil sensitive to light. 
Convexity median, uniform. Pupil black in ordinary light. Lids open and 
mobile. Sclera light pink. Tears clear, limpid without overflow. Lids 
thin, delicate, margins evenly curved. Whole eye responsive to moving 
objects. Defects : small eye : semi-closed, thick, sluggish lids ; convex 
cornea : sunken eye : projecting eye : weeping eye : blear eye : watch eye : 
irresponsive iris : dilated pupil : unequal eyes : flat cornea ; ovoid cornea. 

Much of the expression of the face depends upon the eyes, and 
in animals as in man it is difficult to find compensations for a for- 
bidding countenance. Perfect, sound, intelligent eyes are always 
pleasing ; imperfect, defective, sunken or lifeless eyes mar the 
whole expression. The following points may be specially noted : 

ist. Ample breadth between the orbits. This is of great 
importance in the horse, in which we seek for intelligence, 
courage and indomitable energy. This conformation does not in- 
dicate the size of brain, as the cranium is situated higher up, but 
by placing the eyes well outward, it indicates a wider range of 
vision, and usually implies large, clear eyes, and since interde- 
pendent parts tend to correspond in development and quality, 
this commanding vision bespeaks a large, active brain, intelli- 
gence, docility and activity. 

2d. Full, prominent eyes. This may be excessive, eitheJ 
through primary conformation or disease. Abnormal convexity 
of the cornea implies myopia. But within normal limits the 
prominent eye suggests good health, condition and vigor, with 
ample cushions of fat under the bulb and a sound, well-developed 
condition of the eyeball and its muscles, 

3d. Both eyes equal in all respects. Any variation in 
size, shape, color, fullness, clearness or in any other respect is at 

318 



Diseases of the Eye. 319 

best unsightly, and implies not only defect but often disease as 
well. 

4th. The iris should be lustrous, uniform in color and 
even in surface. Whether dark brown as in the horse, or yel- 
low as in the dog, it should be brilliant. Any part that lacks 
lustre, being lighter brown, or yellow and dull like a dead leaf, 
usually indicates previous disease and a tendency to further 
trouble. Albinos and those in which the pigment is congenitally 
absent in patches must be considered as exceptions, yet, even in 
them, the peculiarity cannot be held to add to the beauty. 

5th. All the Media (Cornea, aqueous humor, lens and vit- 
reous) must be perfectly clear and translucent. The slightest 
cloudiness or opacity in any of these is a serious blemish and 
usually indicates disease, past or present. 

6th. The pupil should promptly and freely respond to 
light and darkness by contraction and expansion. Absence or 
tardiness of movement indicates impaired vision, from disease of 
the eye, its nerves, or their nerve centres. 

7th. Each cornea should have a median convexity, uni- 
form in all directions implying the absence of myopia, 
presbyopia and astgimatism. Any deviation from this will 
interfere with the perfection of sight, and endanger shying and 
other troubles. 

8th. Under ordinary light the pupil should appear black 
throughout. In the larger animals such dilation of the pupil as 
to expose the tapetum lucidum under such circumstances implies 
impaired vision (amblyopia, amaurosis), inflammation of the 
iris or undue intraocular pressure. A white color or spot shows 
cataract. 

9th. The lids must be open and mobile without excessive 
dilation. Tardily moving or semi-closed lids, distorted by scar 
or angle, everted or inverted, are unattractive and usually imply 
disease in the eye, nerves or brain. 

loth. The unpigmented portion of the sclera should be 
light pink. The dark red of congestion and the pallor of anaemia 
are equally objectionable. 

nth. The tears must be clear, limpid and confined within 
the lower lid. Any milkiness, flocculency or overflow is in- 
dicative of disease. 



320 Veterinary Medicine, 

1 2th. The eyelids must be thin, delicate, evenly and 
uniformly curved along the borders, and fringed by an 
abundance of strong, prominent and well directed lashes. 
Puffiness or swelling betrays inflammation, dropsy, anaemia, 
parasitism or other disorder, angularity of the upper lid an in- 
ternal ophthalmia, and depilation or wrong direction of the lashes, 
local disease. 

13th. The eye should respond instantly, by movement, to 
new objects and noises, without showing undue irritability 
or restlessness. The intelligent apprehension of the objects 
will introduce an aspect of calmness and docility. 



DEFECTS, BLEMISHES AND ABNORMALITIES OF THE 
HORSE'S EYE. 

Some of these may be present in the absence of actual disease, 
and yet prove so objectionable that they disqualify the animal for 
any use, in which style or aesthetic appearance is demanded. 
Among such sources of disqualification may be noted : 

ist. The small eye. One or both eyes may appear small 
because of internal pain and retraction within their sockets, or 
from actual atrophy or contraction of the eyeball, the result of deep 
seated disease, or the organ may be congenitally small, and deep 
seated in the orbit, and the thick, tardy eyelids may have a narrow 
opening through which they can only be partially seen. This 
last condition usually implies a dull lymphatic constitution, low 
breeding and a lack of intelligence, docility and vigor. 

2d. The semi-closed eye with thick, coarse, sluggish lids. 
In this case the bulb may not be unduly small, yet as it is not 
freely exposed it conveys the same general expression to the ob- 
server. Like the small eye it indicates low breeding, lack of in- 
telligence or docility and often stubbornness or even vice. 

3d. The convex eye. In this the transparent cornea de- 
scribes the arc of an unduly small circle, suggesting a conical form 
and projecting unduly beyond the margins of the lids. It implies 
imperfect vision, myopia, and, it is alleged, low breeding and lack, 
of alertness. 



Defects, Blemishes and Abnormalities of the Horse's Eye, 321 

4th. The sunken eye. This has been already referred to 
under the small eye. The eyelids are usually flaccid, the upper 
being drawn in by its levator so as to form an angle, and the 
edges of the orbit are somewhat prominent. It is seen in old, 
worn out animals, which have lost the pads of fat in the depth 
of the orbit, and more commonly in animals that have suffered 
several attacks of recurrent opthalmia. 

5th. The projecting eye. In this case the lids are unduly 
contracted and the eye protrudes between them so as to show a 
large amount of sclerotic around the transparent cornea. This 
may be due to nervous strain and suffering but,* however pro- 
duced it is decidedly unsightly and objectionable. 

6th. The weeping eye. This is always a condition of disease. 
It may be due to irritant gases, or solid particles, to inturned 
cilia, everted lids, conjunctivitis or a variety of other conditions. 
A careful examination may show whether it is only a transient 
and remediable fault of a good eye or a permanent and irremedi- 
able defect. 

7th. The blear eye. With swelling and scabbing of the edges 
of the lids and Meibonian glands, and congestion of the adjacent 
conjunctiva, there is usually some blurring of the surface of the 
transparent cornea. The trouble is mostly chronic and consti- 
tutes a serious objection. 

8th. The watch eye. In this, as in the albino, there is a 
lack of pigment, so that the iris and sclerotic are white or bluish 
white in part or in whole. »Such an eye may be good and dura- 
ble, but not beautiful nor attractive. 

9th. Blindness of one or both eyes. In all such cases the 
pupil remains fixed and immovable, showing no accommodation 
to light and darkness, and there is a lack of prompt respon- 
siveness on the part of the eye to sounds and objects. In amau- 
rosis, glaucoma and cataract especially, the pupil remains widely 
open, and alert movements of the ears are employed to make up 
for the lack of sight. The condition often comes from internal 
ophthalmia, such as the recurrent form, and is associated with 
atrophy of the bulb. 

loth. Eyes of unequal size. This usually implies serious 
disease in one, not infrequently recurring ophthalmia. 
21 



322 Vetertfiary Medicine. 

nth. Too flat corneal surface. In this case there is a mani- 
fest lack of the normal projection, the anterior surface of the 
cornea describing the arc of a larger circle, the visual rays coming 
from a distance alone converge on the retina and presbyopia 
occurs. In this as in myopia and other visual imperfections a 
horse is liable to stumble and, if nervous, to shy. 

1 2th. Ovoid cornea. In such cases the front of the trans- 
parent cornea has an ovoid outline the arc formed by it in one 
direction being that of a greater circle, than the arc which crosses 
this at right angles. In consequence of this, the rays impinging 
on the outer portions of these respective arcs do not converge to 
the same point on the retina and a blurred and imperfect image 
results. This astigmatism causes the subject to stumble and, if 
nervous, to shy. 



SYSTEMATIC INSPECTION OF THE EYE. 

System in Bzamination. Eyelids: cilia: lachrymal puncta: mucosa, 
light pink, brick red, yellow, puffy, dropsical : Ciliary vessels deep, immov- 
able ; nictitans ; transparentcomeaequally smooth, glossy, with clear image 
at all points : foreign body on cornea : corneal ulcer : opacities in aqueous 
humor : iris and pupil : corpora nigra : changes in passing from darkness to 
light : pupillary membrane : adhesions of iris : intraocular pressure : con- 
tracted pupil : hole in iris. Oblique focal illumination of cornea, aqueous 
humor, iris, lens, Purkinje* Sanson images. 

In examining animals for soundness and especially the horse or 
dog, the condition of the eye must be made one of the most im- 
portant subjects of inquiry, as a disease or defect may render the 
animal altogether unsuited to the object to which it is destined. 
As in every other field of diagnosis thoroughness is largely de- 
pendent on the adoption of a system which will stand in the way 
of any flaw being too hastily overlooked. Many of the points to 
be noted will be decided at a glance, yet this does not obviate the 
necessity of turning over in the mind, in succession, the different 
points of inquiry, and directing the necessary attention, however 
hastily, to each in turn. The following points should be observed : 

ist. Are the eyelids swollen, hypertrophied or faulty in 
form, position or movements. Faults as thus indicated may 



Systematic Inspection of the Eye. 323 

imply any one of a great variety of disorders which should be 
followed out to their accurate diagnosis. It may be bruises, 
lacerations, punctures, parasites, conjunctivitis, keratitis, dropsy, 
anaemia, hepatic or intestinal parasitism, nephritis, paresis, 
entropion, ectropion, etc. 

2d. Inspect the cilia as regards form, size and direction. 
Absence or wrong direction may imply disease of the Meibonian 
glands, infective inflammation, demodex or other acarian infest- 
ing, or turning in or out in inflammatory conditions. 

3d. See that the lachrymal puncta are open and that 
there is no overdistension of the sac. The overflow of tears 
and the swelling of the caruncle and of the area beneath it will 
often indicate such trouble. In its turn it may imply inflamma- 
tion of the duct, and obstruction by the tenacious mucopurulent 
product, or it may imply merely obstruction of its lower end by a 
dried scab. This last may be seen in the horse, on the floor of the 
false nostril at the line of junction of the skin and mucosa, and in 
the ass, higher up on the inner side of the ala nasi. In excep- 
tional cases it may be desirable to pass a stilet through the canal 
from the puncta downward or from below upward to determine 
whether it is pervious. 

4th. Determine the vascularity of the conjunctiva. When 
free from pigment as it habitually is in pigs and birds this is 
easily done, while in animals like the horse, in which the bulbar 
portion, which covers the sclerotic, is largely pigmented, we can 
scrutinize only the pigment-free parts. In health there should 
be only a few, fine, pink vessels which move with the mucosa 
when pressed aside on the bulb. In congestion the surface may 
appear brick red, and the vessels are irregular, large, tortuous and 
are seen to anastomose at frequent intervals. These move on the 
bulb when pressed. The congestion is usually deepest on the 
palpebral mucosa and in the cut de sac, and may be whitened for 
an instant by pressure through the eyelid. To expose the con- 
junctiva the right fore finger and thumb may be pressed on the 
upper and lower lids respectively of the left eye, and the left 
finger and thumb for the right, allowing them to slide backward 
above and below the eyeball. Another method is to seize the 
cilia and edge of the upper eyelid between the finger and thumb. 



324 Veterinary Medicine, 

and draw it downward and outward from the bulb, and then deftly 
invert it over the tip of the finger. In the old the unpigmented 
conjunctiva may appear yellow from the presence of subcon- 
junctival fat, or this may appear at any age from hepatic disease 
(distomatosis) or icterus. It is swollen, or dropsical in anaemia, 
distomatosis, etc. 

5th. Examine the ciliary vessels whether they are con- 
gested or not. These are distinguished from the conjunctival 
vessels in that they radiate in straight lines outward from the 
margin of the transparent cornea and do not move on the sclerotic 
under pressure. They are enlarged and very red in congestion 
of the ciliary circle and in iritis. In eyes devoid of pigment over 
the sclerotic, there is usually a circular, narrow, white zone be- 
tween the congested area and the margin of the transparent cornea. 

6th. Examine the Membrana Nictitans. See that its free 
margin is uniformly smooth, even, and thin and that there is no 
swelling, congestion nor morbid growth on any part of the 
structure. 

7th. See if the transparent cornea is perfectly and uni- 
formly smooth, transparent and glistening and if it reflects 
clear, erect images of all objects in front of it. The image 
of a round object which shows any irregularity in the curvature 
of its margin implies a deviation from an uniform curvature of 
the cornea : the image narrows in the direction of the smaller arc 
and broadens in the direction of the larger one (see keratoscopy, 
and corneal astigmatism). 

8th. A foreign body on or in the cornea may be recognized 
in a good light, but better and more certainly under focal oblique 
illumination (see this heading). 

9th. A corneal ulcer may be similarly, recognized. It is 
made more strikingly manifest by instilling into the lower cul de 
sac a drop of a solution of fluorescin and rubbing it over the eye 
by moving the eyelids with the finger. This will stain the whole 
cornea. If now the excess of stain is washed away by a few 
drops of boric acid, the healthy part of the cornea is cleared up 
and the ulcer retains a bright yellowish green tint. 

loth. Opacity or Floating objects in the aqueous humor 
(flocculi of lymph, pus, pigment, blood, worms) are always to be 
looked for. They may be detected by placing the eye in a favor- 



Systematic Inspection of the Eye. 325 

able light. They may be still more clearly shown under focal 
illumination (see below). 

fith. Changes in the iris and pupil may also be noticed in 
a good light. The surface should be dark in the horse, and of 
the various lighter shades in the smaller animals, but in all alike 
clear, smooth and polished, without variation of shade in spots or 
patches and without bulging or irregularity at intervals. Apart 
from the congenital absence of pigment in whole or in part, 
which may be found in certain sound eyes, a total or partial 
change of the dark iris of the horse to a lighter red, brown or 
yellow shade implies congestion, inflammation, or exudation. 
The corpora nigra in the larger quadrupeds should be unbroken, 
smooth, rounded, projecting masses outside the free border of the 
upper portion of the iris. They should show a clear, polished sur- 
face like the rest of the iris. The pupil should be evenly oval with 
its long diameter transversely (horse, ruminant), circular (pig, 
dog, bird), or round with an elliptical outline on contracting and 
the long diameter vertical (cat). It should contract promptly in 
light and dilate as quickly in darkness. Place the patient before 
a window, cover one eye so as to exclude light, then cover the 
other eye with the hand and quickly withdraw : The pupil 
should be widely dilated when the hand is withdrawn and should 
promptly contract, and it should actively widen and narrow al- 
ternately until the proper accommodation has been secured. 
Any failure to show these movements implies a lesion in the 
brain, optic nerve, or eye which impairs or paralyzes vision, 
interferes with accommodation or imprisons the iris. In loco- 
motor ataxia the pupil contracts in accommodation to distance, but 
not in response to light. 

1 2th. Other causes of pupillary immobility include: (a) 
Permanence of a pupillary membrane, which has remained from 
the fcetal condition and may be recognized by oblique focal illu- 
mination and invariability of the pupil : (b) Adhesion of the iris 
to the capsule of the lens — complete or partial — in the latter 
case the adherent portion only remains fixed, while the remainder 
expands and contracts, giving rise to distortions and variations 
from the smoothly curved outline : (c) Adhesion of the iris to 
the back of the cornea — complete or partial — and leading to 
similar distortions : (d) Glaucoma in which intraocular pressure 



326 Veterinary Medicine, 

determines a permanent dilatation of the pupil and depression of 
the optic disc : (e) The pupil is narrowed in iritis, and is less 
responsive to atropia or other mydriatic : (f ) Lesions of the oculo- 
motor nerve may paralyze the iris and fix the pupil. The first 
three and the fifth of these conditions may be recognized by the 
naked eye, alone, or with the aid of focal illumination, the fourth 
>may require the aid of the ophthalmoscope and the sixth which 
cannot be reached by such methods, might in exceptional cases 
be betrayed by other disorders of the oculo-motor nerve (dropping 
of the upper eyelid, protrusion of the eyeball, squinting outward). 

13th. Coloboma {fenestrated iris), and lacerated iris are 
recognizable by the naked eye in a good light, or by the aid of 
focal illumination. 

14th. Tension of the eyeball (Tonometry). Elaborate in- 
struments constructed for ascertaining ocular tension are of very 
little use in the lower animals. The simplest and most practicable 
method is with the two index fingers placed on the upper lid to 
press the eyeball downward upon the wall of the orbit using the 
one finger alternately with the other as if in search of fluctuation. 
The other fingers rest on the niargin of the orbit. All normal 
eyes have about the same measure of tension and one can use his 
own eye as a means of comparison. The educated touch is 
essential. In increased tension, the sense of hardness and resist- 
ance, and the indisposition to become indented on pressure is 
present in the early stages of internal ophthalmias (iritis, 
choroiditis, retinitis), phlegmon of the eyeball, glaucoma, 
hydrophthalmos, and tumors of the bulb. 

Oblique Focal Illumination. 

This is so essential to clear and definite conclusions and is so 
easily practiced on the domestic animals that every veterinarian 
should make himself familiar wkh the method. The method is 
based on the fact that when two perfectly transparent media 
touch each other a reflection of luminous rays takes place only 
at the surface. But in case any opacity exists in any part of the 
thickness of one of these media, it reflects the rays from its surface 
no matter what may be its position in the medium. Thus corneal 
opacities appear as gray blotches and under careful focal illumi- 



Systematic Inspection of the Eye, 327 

nation it may be determined whether these are on the conjunctival 
surface, in the superficial or deeper layers of the cornea or in the 
the membrane of Descemet. Similarly cloudiness or floating ob- 
jects in the aqueous, reflect the luminous rays, and so with opaci- 
ities in the lens or its capsule, or in the vitreous. In the same way 
the surface of the iris and corpora nigra may be carefully scrutin- 
ized. For satisfactory examination of the media, back of the iris, 
the pupil should be first dilated, by instillation under the lid of a 
drop or two of a 3 per cent, solution of atropia, and the ex- 
amination proceeded with twenty minutes later. Homatropin is 
preferable to atropin as being less persistent in its action, and less 
liable to produce conjunctivitis. If it fails to produce the requi- 
site dilatation, it may be followed by a drop of a 4 per cent, 
solution of hydrochloride of cocaine, which will secure a free 
dilatation, lasting only for one day in place of seven days as with 
atropin. The cocaine further removes pain and favors the full 
eversion of the eyelids. 

The instruments required for focal illumination are a biconvex 
lens of 15 to 20 diopters, and a good oil lamp or movable gas jet. 
The light of the sun is not satisfactory. The examination ought 
to be conducted in a dark room, or less satisfactorily in semi- 
darkness. The lamp is held by an assistant at the level of the 
eye to be examined, either in front or behind, or first one and 
then the other, so that the rays of light may fall upon the eye 
obliquely. If the lids are kept closed it may be necessary to ex- 
pose the cornea by pressing on the lids with the finger and thumb. 
The light is held 8 or 10 inches from the eye and the lens is in- 
terposed between it and the eye and moved nearer and more dis- 
tant until the clearest illumination has been obtained of the point 
to be examined. In this way every accessible part of the eye 
may be examined in turn. The examiner may make his results 
more satisfactory by observing the illuminated surface through 
a lens magnifying three or four diameters. It is important to 
observe that the eye of the operator must be in the direct line of 
reflection of the pencil of light. 

Cornea. By focusing the light in succession over the different 
parts of the surface of the cornea, all inflammations, vascularities, 
opacities, ulcers, and cicatrices will be shown and their outlines 
clearly defined. By illuminating the deeper layers of the cornea 



328 Veterinary Medicine. 

proper, the lesions of keratitis, opacities, ulcers and cicatrices will 
be shown. To complete the examination of the cornea the light 
should be focused upon the iris so that it may be reflected back 
through the cornea. This will reveal the most minute blood- 
vessels, any cell concretions on Descemet's membrane, or any 
foreign body in the cornea which may have been overlooked. 

Aqueous Humor. Unless the cornea is densely opaque, the 
anterior chamber can be satisfactorily explored by the oblique 
focal illumination. The cloudiness or milkiness of iritis or 
choroiditis furnishes a strong reflection from its free particles of 
floating matter, its blood and pus globules, and its flocculi of 
fibrine. The latter have usually a whitish reflection, the blood 
elements a red (hypohaema), and the pus a yellow (hypopyon). 
The writhing movements of a filaria scarcely need this mode of 
diagnosis. Sometimes, and especially in the horse, detached 
flocculi of black pigment are found floating free in the aqueous 
and are highly characteristic. 

By this illumination one can easily determine the distance of 
the cornea from the iris and lens (depth of anterior chamber) 
which is lessened by the forward displacement of iris and lens in 
undue tension in the vitreous (glaucoma, retinitis, tumors, 
bladderworms) ,or of the iris alone, in irido-choroiditis with accum- 
ulation of exudate in the posterior chamber of the aqueous. The 
depth of the anterior chamber may increase in cases of luxation 
or absence of the lens or softening and atrophy of the vitreous. 

The adhesion of the iris to the back of the cornea may be satis- 
factorily demonstrated by focal illumination. 

Iris. The lesions of the iris are exceedingly common in con- 
nection with recurring ophthalmia in the horse, and examina- 
tions in the intervals between attacks are of the greatest import- 
ance. The eye should be examined as already stated, at a window 
or door, and if available by the aid of a mirror. Any changes in 
form or color, or luster should be carefully noted, any tension of 
the eyeball, or angularity of the upper lid, and any slight blue 
opacity round the margin of the cornea. Then the prompt or 
tardy response of iris and pupil to light and darkness must be 
made out. To complete the test the eye should be treated with 
homatropin for three-quarters of an hour and with cocaine for ten 
or fifteen minutes,and then subjected to oblique focal illumination. 



Systematic Inspection of the Eye, 329 

With partial posterior synechia the rest of the pupil is found 
dilated while the attached portion extends inward remaining fixed 
to the capsule of the lens. If the synechia is complete no dilata- 
tion whatever has occurred. The edges of the adherent iris 
extend inward as adherent projections, and any exposed portion 
of the lens is likely to show black points, the seat of previous 
adhesions that have been broken up. In such cases the periphery 
of the iris bulges forward from the accumulation behind it of 
aqueous humor or inflammatory exudate which cannot escape. 
The discoloration of the iris as the result of inflammation, stands 
out more definitely under the fuller illumination. 

Crystalline lens. In exploring the crystalline lens or its cap- 
sule for opacities (cataracts) oblique focal illumination can be em- 
ployed to the very best advantage, if the pupil has first been 
widely dilated by homatropine and cocaine. The light is con- 
centrated on all parts of the anterior capsule in turn, then in suc- 
cession on the different layers of the lens at all points and finally 
on the posterior capsule. The striking reflection from any 
points of opacity whether pigmentary, gray or pearly white is 
diagnostic, not only of cataract, but of its exact position — an- 
terior or posterior, capsular or lenticular. 

Purkinje-Sanson images. If the flame of a candle is passed 
in front of the eye, at a suitable distance, in a darkened room, 
and the observer looks into the eye obliquely from the opposite 
side, he observes three images of the flame, reflected respectively 
from the front of the cornea, from the anterior surface of the 
lens and from the back of the lens. The image from the cornea 
is erect, bright and clearly defined : that from the front of the 
lens is still erect, but larger and dimmer, because the difference 
between the index of refraction of the aqueous and lens is 
very slight : the third image, which is smaller and clearer than 
the last, is inverted, because the surface of reflection on the back 
of the lens acts as a concave mirror. The beginner may at first 
find it difficult to make out the image from the front of the lens 
but with a little care he can do so, and then by moving the light 
he should cause each image to pass over all parts of the reflecting 
surface in turn. Any unevenness or opacity at any point of the 
reflecting surface, will cause the image reflected from it to be- 
come blurred or diffused as it passes over it and thus, not the 



330 Veterinary Medicine, 

existence only, but the exact seat of such opacity is easily demon- 
strated. Opacities on the cornea cause blurring of the bright, 
erect image of the flame as it passes over that part : opacities on 
the anterior capsule of the lens blur the dim, erect image when 
passed over them : finally, opacities in the body of the lens or 
on its posterior capsule, blur the small inverted image as it passes 
over them. 

Add to this method the oblique focal illumination and the 
images of the flame reflected from the three mirror surfaces 
(cornea, anterior and posterior lens surfaces) are made much 
clearer and more distinct than in any other way. To do this 
effectively the convex lens should be held so as to focus the flame 
in the air nearly in front of the cornea. The Purkinje-Sanson 
images are made very definite and clear. If the lens is ap- 
proached nearer to the eye so as to throw the image of the flame 
within or behind the lens, a gray phosphorescent streak of light 
is seen in the depth of the pupil. This is due to the laminated 
structure of the lens as well as to the fact that the lens itself is 
not perfectly transparent even in its normal condition. The ab- 
sence of the lens or its dislocation and displacement downward, 
below the line of vision may be inferred from the absence of this 
gray luminous reflection under this test. 



OPHTHAI.MOSCOPE. 

Principle of ophthalmoscope : Angle of incident and angle of reflection 
in same line, light close to one side of the eye, reflected into it by a mirror, 
having a hole in the centre for eye of observer. Opacities show a dense 
white in transparent media : if in front of lens move with rolling of eye : if 
behind in opposite direction. To see fundus must use biconvex lens, 
Emmetropic eye : myopic : hypermetropic. Static refraction. Mydriatics : 
Atropine, homatropine, daturine, duboisine, hyoscyamine. 

In the healthy eye, the pupil and iris, and in cataract, even the 
opaque anterior capsule of the lens, can be clearly seen. The re- 
flection of the pupil, however, is dark and no object back of the 
iris can be observed. The* reason of the diCFerence is that the 
rays of light, entering through the whole cornea, are reflected at 
the same angle at which they strike the surface of the iris. The 



Ophthcdmoscope, 331 

angle of incidence is the same as the angle of reflection. In the 
hollow fundus of the eye, however, the light entering through 
the narrow pupil, strikes the fundus at a point which is hidden 
from the observer, behind the iris, and being reflected by the 
concave fundus, in exactly the same line along which it entered, 
it remains invisible. To illuminate the fundus of the eye, for 
the observer, his line of vision must be made exactly the same as 
that in which the pencil of light enters the fundus. This is best 
effected by reflecting the light into the eye by the aid of a small 
plane or concave mirror having a hole in the center through 
which the observer looks into the pupil. The concave mirror 
gives the stronger illumination, but the plane article is more 
easily manipulated and tends to cause less active contractions of 
the pupil. This is the simplest form of ophthalmoscope. For 
careful examination of the fundus of the eye, it is best to have 
the subject in a dark chamber, with a single large flame of an oil 
lamp or gas (electric light with an obscure globe may answer). 
The light is held behind and on the same side as the eye to be 
examined, at the level of the eye and the perforated mirror and 
the eye of the observer are kept from 10 to 20 inches in front of 
the eye and also at the same level. For the horse or ox under 
favorable conditions in a stall, the light of day coming from a fan- 
sash over the door may serve the purpose. Nicholas assures us 
that it may be accomplished even under the shadow of a shed or a 
tree. In such a case it is better not to have too much glare of 
light as the reflection from cornea and lens may prevent accurate 
observation. A somewhat cloudy day may therefore prove ad- 
vantageous. 

In focusing the reflected light on the cornea, and then on the 
pupil and lens, any opacities in these will be shown as a grayish 
nebular reflection or a denser white according to their degree of 
opacity. The opacities in the cornea or aqueous, in front 
of the axis of vision in the lens, move in the same direction and 
to the same degree as the eye rolls, while opacities on the pos- 
terior capsule or in the vitreous, move in a direction opposite to 
the motions of the eye, and to a degree corresponding to their 
distance back of the lens. Thus if the eye looks downward such 
opacities move upward ; if it looks upward they move downward ; 
if it looks inward they move outward ; and if it looks outward 
they move inward. 



332 Veterinary Medicine, 

To secure an image of the fundus of the eye, including the 
entrance of the optic nerve (optic papilla), the tapetum, the 
pigmentary surface and retina and vessels, accommodation must 
be made for the normal refraction of the eye of the patient, and 
even for that of the observer. 

In the emmetropic (normal) eye, the rays leave the surface 
of the cornea parallel to each other and it may be possible for the 
observer to secure a good image on his retina, without the aid of 
lenses. In the myopic (short sighted) eye they assume a con- 
vergent course on leaving the cornea, and to secure a satisfactory 
image a biconcave or plano-concave lense must be interposed be- 
tween the cornea of the patient and the eye of the observer. 

In the hypermetropic (long sighted) eye, the rays diverge in 
leaving the cornea of the patient, and a convex lens must be 
interposed between this and the eye of the observer, in order that 
the rays may be focused on the eye of the observer. 

To adapt the vision to the diCFerent eyes the modem ophthalmo- 
scope is furnished with a series of lenses concave and convex, any 
one of which can be moved behind the hole in the mirror to suit 
the demands of the particular case. 

To make a satisfactory examination the pupil should be dilated 
as for oblique focal illumination. A i : 200 solution of apomor- 
phia may be instilled into the eye (a drop or two) and in 20 to 25 
minutes a satisfactory dilatation will have been secured. The 
eCFect of the homatropin will usually have disappeared in twenty- 
four hours. 

Determination of Static Refraction. 

This can best be done in the lower animals by determining the 
strength of the lens required to render clear the image of its 
fundus. By knowing the refracting power of the lens, we may 
ascertain what deviation from the normal refraction there is in 
the eye under observation. 

In making this test the mirror of the ophthalmoscope must be 
brought closely to the eye of the patient — i to 2 inches. 

If in such a case and without the use of any lens a distinct 
image of the fundus is obtained, and if this is rendered less dis- 
tinct by interposing the lowest convex lens in front of the eye of 
the observer, the eye is emmetropic. 



ophthalmoscope, 333 

If the ophthalmoscopic mirror without a lens gives an indis- 
tinct vision of the fundus, and if the image is rendered clear by 
interposing one of the convex lenses, the eye is hypermetropic. 
The strength of the convex lens, -f i, + 2 or + 3, dioptrics will 
give the measure of the hypermetropia. 

If, on the contrary, the ophthalmoscopic mirror gives an indis- 
tinct image of the fundus, which is rendered even more indis- 
tinct by the interposition of a convex lens, but is cleared up and 
rendered definite by a concave lens, the patient is myopic. The 
strength of the concave lens used will give the degree of myopia^ 
— I dioptric, — 2 dioptrics, etc. 

The tendency in the horse is constantly to slight long-sighted- 
ness, but the deviation is rarely fpund to be serious either in this 
direction or in that of astigmatism. 

Mydriatics. 

Dilation of the pupil by mydriatics (mydriasis, dilation of the 
pupil) is a most important means of diagnosis, and therefore a 
knowledge of the action of the different mydriatics is essential. 
The mydriatics in common use not only dilate the pupil, but also 
paralyze the ciliary body and the power of accommodation in 
ratio with the strength of the solution employed. This determines 
an adaptation of the eye to the farthest point of vision and holds 
it there until the action of the mydriatic passes off and normal 
power of accommodation is restored. In short it renders the sub- 
ject long sighted, during its action. 

Atropine the alkaloid of atropa belladonna is the most gener- 
ally available and persistent of the mydriatics, and is in most com- 
mon use. It is usually employed as sulphate of atropine, though 
some prefer the nitrate, the salicylate or the borate to obviate the 
danger of atropinism. This form of poisoning may show in the 
occurrence of conjunctivitis and in case of one attack the suscepti- 
bility to atropine is greatly to be dreaded, so that it should never 
again be used on the same subject. The real cause of atropinism 
is uncertain, it has been variously ascribed to too great acidity or 
alkalinity or to micro-organisms growing in the solution. Hence 
the importance of using the antiseptic salts of atropine, and of 
testing the solution to see that it is exactly neutral before it is 
applied. 



334 Veterinary Medicine, 

The strength of the solution of atropine is an important con- 
sideration. Bonders found that i : 1 20 of water produced a full 
effect, while Jaarsma obtained the full effect in one hour from a 
drop of a solution of one to twelve hundred of water. The action 
on carnivora (dogs^nd cats) is equivalent to that on man, while 
on the herbivora (rabbit, horse, ox, sheep) it is somewhat less, 
and on birds very slight indeed. On diseased eyes a large amount 
may be required, and with senechia (adhesion of the iris to the 
capsule of the lens) dilatation may be impossible. The full 
effect may last 24 hours, and accommodation may remain very 
imperfect for 1 1 days. 

The direct action of atropine on the eye is shown in dilatation 
of the pupil of the frog after the eye has been detached from all 
connection with heart or brain, by excision. It acts also in the 
normal system through reflex nervous action, since, after division 
of the sympathetic trunk going to the eye, that eye does not di- 
late so much under atropia as the opposite eye. 

Atropine is usually employed by lodging a drop in the pouch 
of the conjunctiva (inside the lower lid), and from this it makes 
its way into the aqueous humor, for if that liquid is transferred to 
the conjunctiva of another animal it causes dilatation. Puncture of 
the cornea with evacuation of the aqueous humor lessens the action 
of the atropine. Atropine dilatation is increased by following it 
with cocaine which causes contraction of the iridian vessels, the 
antithesis of the dilatation of the vessels which occurs when the 
cornea is perforated and the pressure of the aqueous humor is re- 
moved. 

Atropine is one of the most potent poisons and must be used 
with caution especially in the carnivora and omnivora. The 
danger lies not alone in the absorption from the conjunctiva, but 
also from the escape of the liquid through the lachrytno-nasal 
duct, to the nose and later to the actively absorbing mucosae of 
the lungs and stomach. 

The symptoms of general poisoning are : rapid pulse, vertigo, 
weakness of posterior limbs, general prostration and thirst or 
dryness of the throat. 

Homatropine is an oily liquid produced by the action of 
muriatic acid on the cyanate of atropine. With hydrobromic 
acid it forms a readily crystallizable salt, the solution of which 



Wounds of the Eyelids, 335 

acts on the eye like atropine, but more promptly and transiently. 
One drop of a solution of one to one hundred and twenty, usually 
gives in twenty minutes, full pupillary dilation and complete 
paralysis of accommodation which lasts only for twenty-four 
hours. Add to this that there is little danger of constitutional 
disturbance and poisoning, and homatropine must be accepted as a 
more desirable agent than atropine. It is especially to be preferred 
in cases of senility with shallow anterior chambers, and in glau- 
coma, in which atropine tends to aggravate the lesion. 

Daturine, the alkaloid of datura stramonium is a potent my- 
driatic, causing pupillary dilatation in a solution of one to one 
hundred and sixty thousand of water. It appears to be identical 
with atropine. 

Duboisine, the alkaloid of duboisia myoporoides is also a 
potent mydriatic. Jaarsma found that a solution of the sulphate, 
of one to three thousand, paralyzed accommodation for twenty- 
four hours. It acts more promptly than atropine but is more 
poisonous. 

Hyoscy amine, the alkaloid of hyoscyamus niger, is also 
strongly mydriatic. One drop of an one to three hundred solu- 
tion of the sulphate paralyzed accommodation for from seventy- 
five to one hundred hours. Risley found it to act more promptly 
than atropine, and to be less dangerous than duboisine. 



WOUNDS OF THE EYELIDS. 

Traumas : bites, lacerations,blows, penetrating wounds, gunshot, scratches, 
kicks. Upper lid or commissure. Reparatory power of eyelid. Danger of 
distortion. Treatment : sutures, plaster, shellac, collodion, gelatine. Prick's 
gelatine, birdlime, sterilisation : Quilled and twisted suture. Position in 
stall. Metallic guard for eye. 

Causes. Traumatic injuries of the eyelids are especially com- 
mon in the horse mainly because of his exposure in connection 
with the services required of him. In a team he is liable to be 
bitten by one of his fellows, or the lid may be caught on nails, 
in turning, or on hooks upon harness, chains or wagons. It 
is sometimes injured by a blow from a club or whiplash, or 



336 Veterinary Medicine. 

by knocking the head against solid objects that he failed to 
see on account of the blinds. Again the injury will come from 
running against prongs of bushes or trees, or of stump fences. 
Occasionally a blow with the horn of an ox or cow is the cause, 
but this is much more frequent with the bovine races. Then 
again gunshot wounds are found in all animals. In sheep the 
eyelids sometimes suffer from bites of dogs, while in dogs and 
cats, the teeth and claws are the main causes of injury. These 
smaller animals also suffer from brutal blows and kicks. 

Nature, Wounds of the eyelids almost invariably affect the 
upper lid, because of its extra size and prominence. Sometimes 
one commissure or the lower lid is the injured part. 

Clean incised wounds are rare, while lacerations, with or with- 
out contusions are the common experience. The laceration often 
extends through the free margin of the lid, and then to one 
side, mostly the outer, in a direction more or less parallel to the 
tarsus. The result is that the detached flap drops downward 
exposing a greater or less portion of the bulb covered with blood. 
The conjunctiva, the cornea, the sclerotic or iris may be impli- 
cated in the lesion in different cases, so that such wounds are of 
the most varied degree of gravity. If, however, the lesion is 
confined to the lid, and in the absence of absolute detachment of 
the flap, or severe contusion, a good repair may be confidently 
hoped for. The vascularity and reparatory powers of the eyelid 
are unusually great, and the looseness of the skin, connective tis- 
sue, mucosa, and even the muscles is such that they do not draw 
injuriously upon the edges of the wound to disturb the process 
of cicatrisation. If the two opposing ends of the divided tarsal 
cartilage are kept in accurate apposition, the elasticity of this 
structure serves to preserve the even contour of the palpebral 
margin, and the adhesion or granulation process between the edges 
of the wound, soon becomes firm enough to prevent further dis- 
placement. Even when one- half of the eyelid is torn loose, remain- 
ing attached only by a narrow portion, reunion without any un- 
sightly distortion is not to be despaired of. In case of a mere vertical 
laceration on the other hand, the case is very simple and hopeful. 
Even when a portion of a lid has been completely torn off and 
lost, the loose textures of the remaining part, often appear to 
stretch in the process of healing so that a fairly serviceable^ 



Wounds of the Eyelids. 337 

though by no means an aesthetic covering for the eye may remain. 
This may serve for a common work horse, but the unsightli- 
ness would necessarily debar him from use in a carriage or as a 
saddle horse. The imperfect protection too, exposes the eye 
to rainstorms, hail and snow, as well as to dust, and greatly 
predisposes to conjunctivitis. 

Treatment. One can trust implicitly to the extraordinary re- 
paratory power of the eyelids, yet so unsightly is any distortion 
of these parts, that the greatest pains must be taken to obviate 
loss of substance, or unevenness or puckering in healing. The 
points to be mainly sought for are the perfect coaptation of the 
divided edges, and the restraining of the patient from interrupting 
the healing process and breaking loose the forming adhesions, by 
rubbing the eye. 

Inconsiderable wounds of the skin may be simply stitched 
together with sterilized catgut. Then the intervals between the 
stitches may be approximated, dried, and covered with strips of 
sticking plaster, or with shellac, collodion or gelatine. Prick's 
gelatine is made by dissolving fine gelatine in a i per cent, solu- 
tion of corrosive sublimate and adding about 10 per cent, of glycer- 
ine, perfecting the admixture by the aid of heat. When wanted 
for use it may be melted by heat and applied on the skin with a 
camePs hair brush. Bird lime may be used as a substitute. 
Sterilization must be sought by the use of sublimate lotion i : 2000, 
or boric acid 2 : 100. Formerly the edges were kept in close 
opposition by the use of quilled sutures, the stitches passed around 
the quills being inserted at the usual distances while the quills, 
applied against the edges of the wound kept them smooth and 
even and obviated puckering. Or, perhaps better, the twisted 
suture may be employed, the edges being brought together by 
pins placed close together and a silk thread carried around each 
in figure of 8, and spirally from pin to pin along the entire length. 
If one pin comes out it ought to be promptly replaced and the 
whole left in place until a firm adhesion is established. The 
points of the pins are cut off short so that there may be no risk of 
their pricking. 

With any method the horse or ox may be turned in his stall so 
that his tail may be toward the manger and his face outward, and 
he may be tied by two halters to the two posts, right and left. His 
22 



338 Veterinary Medicine, 

food may be furnished in a sack hung from the ceiling and cut 
down one side. In this way the animal may be absolutely pre- 
vented from rubbing the itching sore against any solid body, and 
thereby interrupting the healing process. Another method is to 
apply a hood of stiflF material with a metalKc guard for the face, 
having bars extending from above downward and arched outward 
so that they shall eflFectually protect the eye in any attempt at 
rubbing. 



DEFICIENCY OF THE EYELIDS. COLOBOMA PALPE- 
BRARUM. 

The term coloboma representing merely a hiatus or deficiency 
is applied to different parts of the eye according as there may be 
a lack of substance of the part in question : — Coloboma palpe- 
brarum (deficiency of the palpebrae or lids), C. iridis (perfora- 
tion of the iris), and C. choroidese (partial absence of the 
choroid). 

Coloboma palpebrarum is usually congenital and takes the 
form of a vertical notch on the upper lid, separating its two 
lateral parts into independent flaps. According to the breadth 
and depth of the notch are the extent of the exposure of the 
bulbar conjunctiva and the liability to irritation and infection by 
foreign bodies. The same condition of things will occur trau- 
matically and require identical measures of repair. These con- 
sist in paring the edges of the notch and bringing them accu- 
rately together with cat gut, silk or quilled suture, the approxi- 
mation being rendered more perfect by the application of col- 
lodion, shellac or gelatine mixture (see wounds of eyelids). The 
vascularity and extensibility of the tissues of the lids greatly 
favor a kindly healing. Rubbing of the eye must be guarded 
against as advised under wounds of the eyelids. 



ORGANIC UNION OF THE EYELIDS. ANKYLOBLE- 
PHARON. NARROWED FISSURE BETWEEN THE 
LIDS. BLEPHAROPHYMOSIS. 

Complete closure of the palpebral fissure has been seen as a 
congenital infirmity in sheep, dogs and cats, while the partial 
closure has been found in all classes of animals as the result of 
chronic conjunctivitis and contraction of the exudation in under- 
going organization. Narrowing of the fissure gives the appear- 
ance of a small eye, so that a progressive diminution is usually 
supposed to come from a reduction in size of the bulb, though no 
actual atrophy of that organ has taken place. In drooping of 
the upper lid (ptosis) too, the fissure is reduced and the illusion 
of an atrophy of the eyeball is induced. The closure of the 
fissure may come from blepharospasm^ as the result of irritants 
in the eye, or even of nervous disorder. 

Treatment. In case of complete closure of the palpebral 
fissure, the skin is picked up with forceps and an incision is made 
between the two tarsi into the conjunctival sac. Then with 
probe pointed scissors, or a grooved director and bistuory the in- 
cision is carried between the tarsi to the proper position for the 
internal and external canthi. During healing the lids should be 
frequently bathed with a boric acid solution, and an ointment of 
the same with vaseline should be applied to prevent adhesion. 

When the trouble consists in a drawing together of the skin at 
the outer canthus, the result of inflammation, the adhesions are 
separated by a horizontal incision leading outward from the line 
of the angle. The edges of the conjunctiva and skin are then 
sutured together, so as to prevent further adhesion and the part 
treated as an ordinary wound. This is known as canthoplasty. 

Ptosis coming from tumors on the lid, or excess of fat in its 
substance, or from oculo-motor disease must be treated according 
to indications. The same remark applies to spasm of the orbicu- 
lar muscle ( blepharospasm ) , whether clonic or tonic. In domestic 
animals the removal of the cause (foreign body, eyelash), will 
usually succeed. 
339 



WIDENED PALPEBRAL FISSURE. 

After wounds of the outer canthus the union of the edges may 
remain imperfect so that the fissure is enlarged and the eye un- 
duly exposed. The case is still worse if the wound has deviated 
from the horizontal and has involved the orbicular muscle, the 
divided ends of which continue to draw the edges apart, and 
cause a constant overflow of tears (epiphora). Enlargement of 
the bulb or its protrusion by reason of a swelling beneath it may 
give rise to the same appearance (exophthalmos). 

Treatment, Pare the edges of the upper and lower lids at the 
outer canthus and bring them together by sutures. 



LAGOPHTHALMUS. INABILITY TO CLOSE EYELIDS. 

This is called hare-eye (lagos, hare) from the fact that the 
hare habitually keeps the eyelids open. It is mostly due to 
spasm of the levatores palpebrae, or to undue size of the orbicular 
opening. It may, however, accompany ectropion, exophthalmos, 
and enlargement or swelling of the eyeball from any cause. 
Bayer has seen cases in diseases of the trifacial nerve, in neo- 
plasms in the orbit and in buphthalmus. 

Cases of the kind are especially liable to irritation, inflamma- 
tion and ulceration due to foreign bodies falling on the exposed 
bulb. 

The treatment is largely that of the attendant condition ectro- 
pion, tumor, etc., which may be consulted. 



340 



ADHESION OF THE EYELID TO THE BULB. SYM- 
BLEPHARON. 

Causes : Conjunctivitis, bums, operation and other wounds. In front of 
or behind the reflection of the mucosa from eye to lid. Prevention. Treat- 
ment : section of adhesion, and vaseline, etc. Two edges of healthy mu- 
cosa sutured together over the sore. When fornix is implicated mucosa is 
transplanted. 

This is liable to occur to a greater or less extent, in all animals, 
in connection with violent conjunctivitis, bums and operation 
and other wounds. It has been divided into anterior and pos- 
terior sytnblepharon, the former being an union in front of the 
normal reflection of the conjunctiva from the lid upon the bulb 
(fornix), and the latter involving the fornix in the substance of 
the adhesion. The afiterior form by anchoring the lid to the 
eyeball is much more likely to induce blindness, but it has the 
compensation that the union may be broken up and the parts 
healed without subsequent reunion. In the posterior form the 
eye can be better exposed and vision retained, its repair is much 
more difficult demanding transplantation of skin or mucous mem- 
brane on to the sore, and even then the granulation tissue being 
continuous from bulb to eyelid may so contract in healing as to 
leave matters no better than before. 

These adhesions not only restrict the movements of the lids, 
preventing their opening and the exposure of the bulb, but they 
also anchor the bulb itself, and hamper its movements, neces- 
sitated for vision. In all cases therefore of wounds, burns, abra- 
sions and ulcers, of the palpebral and bulbar mucosae it is highly 
important to take precautions against the formation of such con- 
nections. Any forming adhesions must be broken up day by day 
and the surfaces must be kept apart in the intervals by borated 
or iodoformed vaseline. 

In a small anterior symblepharon the connections may be cut 
through and subsequent adhesion prevented by the frequent in- 
troduction of iodoformed vaseline, and if need be, by the daily 
separation of the surfaces by a probe. When this fails a plastic 
operation may be resorted to, the mucosa on the inner side of the 
341 



342 Veterinary Medicine. 

lid being incised in a vertical direction a short distance on each 
side of the sore and the inner edges accurately stitched together. 
The raw surface left on the bulb thus comes in contact only with 
the healthy mucous strips on the eyelid, which have been drawn 
together over the seat of the former sore, and the two new raw 
surfaces formed on the lid are well to each side of the sore on 
the bulb, and "are in contact with its healthy mucosa only. Thus 
no two raw surfaces can come in contact, and adhesion is obviated. 
When the fornix is implicated mucous membrane from the 
mouth, vulva, the bronchia of the rabbit, or the skin of the frog 
must be transplanted after the requisite incision of the cicatrix 
has been made. 



INFLAMMATION OF THE EYELIDS. BLEPHARITIS. 

Phlegmon. Causes :.tranmas, skin disease. Symptoms : swelling, red- 
ness, distortion, infiltra ion, semi- closed lids, scabs, sloughs, abscess. 
Tenderness. Itching. In eczema papules, vesicles, weeping eye. Treat- 
ment: antiseptic astringent lotions, almond oil, vaseline, zinc oxide, 
salicylic acid« boric acid, starch, xeroform, pyoktannin ; for eczema, mer- 
cury oxides, silver nitrate, collargol. 

Conjunctivitis will be treated later, and under the present head 
there will be considered only the phlegmon of the outer structures. 

Causes, This lesion may come from two distinct causes, traum- 
atism and skin disease. The traumatisms in horses and cattle are 
bruises sustained in rolling, especially during colics, in striking 
the head against posts, poles, shafts and other solid bodies, in 
enduring blows with horns or clubs, or frictions by the halter or in 
putting on a collar. Dogs suffer especially from blows with clubs 
and kicks from men or animals. All may suffer from wounds of the 
lids, and from extensions of eczema, acariasis and other skin dis- 
eases. 

The symptoms consist in swelling, redness, distortion, and often 
extensive infiltration of the lid, some times eversion with exposure 
of the reddened conjunctiva, usually abrasion, contusion, puncture 
or laceration, semi-closed eye, the upper eyelid being compara- 
tively immovable (ptosis), and the formation of scabs, sloughs, 
or abscess. There may be extreme tenderness, or, more com- 



Inflammation of the Eyelids, Blepharitis, 343 

monly, intense itching. Where eczema exists there may be 
found minute shot-like papules at times surmounted by small 
vesicles and the skin disease is continuous backward upon the 
face. When abscess forms, the rounded swelling and manifest 
fluctuation will betray its presence. Usually the eye waters and 
the side of the cheek is wet and the hairs matted by a whitish 
coagulated lymph and mucus. 

Treatment, In the early stages without scabs, sloughs, or ab- 
scess, antiseptic astringent lotions are in place. Weak solutions 
of zinc sulphate, boric acid and morphine may be kept applied 
on a light bandage. Or silver nitrate i gram to i oz. water may 
be applied daily with a fine brush. 

When scabs and crusts have formed they may be softened by 
the application of almond oil, and then removed. The surface 
may then be dusted with a bland antiseptic powder such as : 
zinc oxide 10 parts, salicylic acid i part ; or boric acid and starch 
equal parts ; or iodoform ; or xeroform. Or unctuous applica- 
tions may be used : zinc oxide 10, salicylic acid i, vaseline 10 ; 
or iodoform i, vaseline 5. Or a watery application may be used, 
such as the silver lotion or that of pyoktannin i : 1000, 

For eczema yellow oxide of mercury i, to vaseline 10, has an 
excellent reputation. It may be alternated with pyoktannin. 

When abscess has formed it should be incised in a line parallel 
to the free border and the resulting cavity injected with the silver 
or the pyoktanin solution. 

In all cases the patient must be fastened as for wounds of the 
lids so that he cannot rub the eye. 

For eczema, acariasis and other skin diseases the special treat- 
ment appropriate to the disease should not be omitted. 



CEDEMA OF EYELIDS. 

In anthrax, malignant oedema, disease of heart, kidney or liver, distoma- 
tosis, trichiniasis, wasp stings, urticaria, petechial fever. Treatment : cor- 
rect general disorder, remove local irritant, antiseptic astringents. 

An oedematous condition of the eyelids with or without in- 
flammatory conditions may be due to local disease or it may be 
the result of more general disorder. In anthrax districts any of 



344 Veterinary Medicine, 

the herbivora, but especially cattle and sheep, are liable to a dif- 
fuse anthrax of the eyelid with a special petechial or brownish 
condition of the palpebral conjunctiva. Malignant cedema and 
other local bacteridian affections affect the loose textures of the 
eyelid in a similar manner, but with extrication of gas and crack- 
ling under pressure. Such cases are complicated by local in- 
flammation. When in the absence of inflammation the lids pit 
on pressure, one should seek for some disease of the heart, kid- 
ney or liver, also for indications of similar dropsical effusions in 
other parts of the body. Distomatosis and to a less extent, pul- 
monary and duodenal strongylosis are especially common factors 
in sheep. In distomatosis (liver rot) a simultaneous dropsy is 
often present in the intermaxillary space, the chest or the ab- 
domen. The puffiness of the eye is especially marked in the pal- 
pebral conjunctiva, and is exposed by everting the eyelid over 
the tip of the finger. In trichinosis in man and less frequently 
in swine, dropsy of the eyelid is often present at the end of 
the first week. Other swellings of the lids partaking more of the 
nature of inflammation, result from the stings of wasps, hornets 
and other insects, from urticaria (in horses especially) and from 
petechial fever in solipeds. 

In treating such cases the general disorder, if present, must be 
first attended to, then the removal of any local irritant, and finally 
the antagonizing of any local inflammation or infection. Astrin- 
gent and antiseptic lotions are especially called for. 



EMPHYSEMA OF THE EYELIDS. 

This has been already referred to as occurring in malignant 
cedema, black quarter and other gas producing infections. It 
may also come from lacerations made in puncturing the lachrymal 
sac, and from fracture of the margin of the orbit — the air enter- 
ing the connective tissue in this case from the cavities of the 
nasal sinuses. The lid feels puffy and crackles when pressed and 
apart from a general infection it requires only soothing and anti- 
septic dressings. 



DISEASE OF THE MEIBOMIAN GLANDS. BLEPHAR- 
ADENITIS. SEBORRHCEA. 

This is a blepharitis of the edges of the lids which are swollen, 
red, and incrusted along their margins with scabs and sebaceous 
concretions. When this scurf is removed the skin is found to be 
red, tender and glistening. The glands are the seat of conges- 
tion, and produce a modified secretion in excess, which dries into 
crusts instead of preserving its normal oleaginous consistency. 
As these glands open into the follicles of the eyelashes, their 
walls are implicated and shedding of the lashes is a common re- 
sult. It may be assumed that this affection is often associated 
with the proliferation of microbes in the glands and gland ducts, 
while in other forms the presence of acari is the controlling fac- 
tor. Wilson found the demodex foUiculorum in the Meibomian 
glands of the horse, Oschatz in those of the sheep, and others in 
those of the dog. 

Treatment, Smear the margins of the lids with vaseline and 
when the crusts have been thoroughly softened wash them off 
with Castile soap and warm water. Then dress the margin with 
the ointment of the yellow oxide of mercury i, in vaseline lo. 
If demodex is suspected they may be squeezed out and the lids 
washed frequently with spirits of wine as a solvent. 



HORDEOLUM. STYE. ACNE. 

Like acne of the skin in general, this consists in inflammation 
and suppuration of a hair follicle and sebaceous gland. The 
whole lid or a large part of it may be swollen, but by stroking it 
with the finger, a hard, rounded, very tender spot will be de- 
tected, and as the disease advances this develops a minute collec- 
tion of pus. A specially wide orifice favors the entrance of the 
pus microbes, and the onset of the disease. It has been noted in 
dogs (Frohner). 

For abortive treatment Fick recommends dry heat from a pocket 
handkerchief or a heated teaspoon. If pus is present it must be 
evacuated, and recurrence guarded against by cleanliness and 

345 



346 Veterinary Medicine, 

antiseptics. Use pyoktannin solution (i : looo), or mecuric 
chloride (i : 5000) or yellow oxide of mercury ointment. 



CHALAZION. 



This is a pea-like tumor growing from the tarsal cartilage, its 
flattened side toward the mucosa, which is red and angry, and 
its round surface toward the skin. When manipulated between 
the fingers it moves with the tarsus. It is usually of sl6w growth 
and may contin\ie for years apparently unchanged. Some have 
thought it tuberculous, but its true nature is uncertain. Warner 
records the disease in the horse. 

Treatment consists in incision and removal of the tumor, cur- 
retting of the cavity, and after antiseptic douching, suturing the 
lips. 



TUBERCULOSIS OF THE EYELID. 

Described by Jewsejenke in the lower lid of birds, this is mani- 
fested by small, hard round knots, covered by bluish red, or yel- 
lowish red skin, and when incised showing a characteristic miliary 
tubercle, with bacilli and sometimes a caseated centre. It is 
treated by incision, curretting and caustics. 



TURNED-IN EYELASH. TRICHIASIS. 

Sometimes an eyelash grows inward so as to impinge upon the 
front of the eyeball, or even to extend between this and the eye- 
lid. The condition exists in entropion but trichiasis is rather the 
deviation of one or two cilia by reason of their false direction, in- 
dividually. It may occur as the result of a pre-existing inflam- 
mation affecting the edge of the lid and the follicle, and the 
offending hair is not only badly directed but small and shrunken 
as well. On this account it is not always easy to recognize it, 
and accordingly in cases of conjunctivitis without apparent cause 



Entropion, Turning in of the Eyelid, 347 

it is well to examine carefully with the aid of oblique focal 
illumination. 

Treatment consists in pulling out the offending hair with ciliary 
forceps, avoiding bending it lest it break off short and become at 
once more irritating and more difficult of extraction. In case 
the hair grows anew in the same direction extract it anew and 
destroy its root with the electric cautery. Or the cilia being 
drawn out with a smooth ring or spatula, an incision is made on 
the inner side of this, between the tarsal cartilage and the orbic- 
ular muscle. The skin is drawn out by plaster, or stitch, or 
plastic operation, and the wound allowed to heal by granulation. 



ENTROPION. TURNING IN OF THE EYELID. 

In foals, puppies, hounds, with narrow fissure, and conjunctivitis, or 
tarsitis. Permanent bandaging, orbicularis spasm. Symptoms : disappear- 
ance of tarsus and lashes by involution. Treatment : in spasm fix by plas- 
ter ; suture skin : excise elliptical section of skin and suture edges together. 
Release cicatrices. 

Inversion of the eyelid or a portion of it, with consequent 
trichiasis, conjunctivitis and lachrymation has been met with con- 
genitally in foals (Aubry, Bourdeau, Hamon) and puppies 
(Cadiot, Almy). Hounds have especially suffered. In the older 
animals it is largely determined by abnormally narrow fissure, 
and by old standing disease of the conjunctiva or tarsus, with 
cicatricial contraction or adhesion. Persistent bandaging turns 
in the cilia and contributes to entropion. Finally a persistent 
spasm of the orbicularis muscle may bring it about. 

Symptoms, Trichiasis is usually, though not always, present. 

In any case the tarsus is turned inward so as to press upon the 
front of the bulb, or even to disappear completely. Thickening 
and distortion of the lid is a not infrequent condition. 

Treatment, In case of simple spasm clip or shave the hairs 
from the lid corresponding to the lesion, and close to the tarsus 
attach a strip of plaster. When firmly adherent draw it suffi- 
ciently to efface the entropion and attach it to the skin of the 
face. 



348 Veterinary Medict7ie, 

This failing, Gaillard's sutures may succeed. With a pair of 
forceps with looped, transversely elongated blades, pinch up skin 
and muscle sufficient to correct the entropion, and passing a 
needle twice through this fold with an interval of 3 m m., tie 
the suture over a small roll of cotton. The stitches may be re- 
moved in two days and the cicatrices may permanently obviate 
the deformity. 

The older plastic operation is more trustworthy : The skin of 
the affected lid is pinched up to such an extent in length and 
breadth, as to correct the entropion and is then excised with 
sharp scissors or bistuory so as to leave a long elliptical sore. 
The edges of this are then carefully sutured together and the re- 
sulting union corrects deformity. Frohner excises a circular 
piece of skin and allows it to contract and heal by granulation. 
In case the entropion is caused by an old standing cicatrix, it may 
be necessary, first, to make a careful incision along the edge of 
the lid so as to separate the tarsus and conjunctiva from the cilia 
and Meibomian ducts, and then to proceed with the plastic oper- 
ation on the skin. 



TURNING OUT OF THE EYELID. ECTROPION. 

In large dogs, in old age, debility, conjunctival swelling, cicatrized skin 
of lids, distortions of lids. Symptoms : exposure of pelpebral mucosa* 
weeping eyes, conjunctival hypertrophy (chemosis). Treatment: tcarify 
or excise a fold of muco'ta, astringent antiseptics, Snellen's suture, Diefen- 
bach's operation, Wharton Jones operation. 

This is much more common than entropion, but much less in- 
jurious as the tarsi and lashes do not irritate the conjunctiva. It 
is especially common in large dogs (hounds, mastiff) and usually 
affects the inner part of the lower lid. Old age and debility con- 
tribute materially to the condition, the lack of tone or paresis 
being an important factor. It may, however, occur in any ani- 
mal, from conjunctivitis and swelling of the mucosa, from cica- 
trices or old standing disease of the skin of the eyelids, or from 
imperfectly healed wounds leaving distortions of the lower lid. 
It is most frequent in the lower lid, and the slightest pendulous 
condition, which detaches the tarsus from the bulb, and exposes 
a narrow zone of the conjunctiva is considered to be an ectropion. 



Turning Out of the Eyelid, Ectropion, 349 

Symptoms, Beside the exposure of the zone of mucosa, there 
is the overflow of tears, and in old standing and bad cases a 
hypertrophy of the exposed conjunctiva, which projects as a 
fleshy-looking mass, and weighs down the lid, with a continual 
tendency to aggravation. 

Treatment. Where the main factor seems to be the infiltration 
of the mucosa this may be reduced by scarification, or by the 
complete exdsion of a fold of the membrane. Use an antiseptic 
wash (boric acid) and the retraction of healing tends to brace up 
the lid against the bulb. 

Snellen* s suture is sometimes employed successfully. A silk 
thread is armed at each elid with a needle, and the needles are 
passed into the conjunctiva just inside the tarsus and brought 
out through the skin near the margin of the orbit, where they 
are tied round a small roll of cotton. Several of these may be 
inserted side by side so as to extend the whole length of the 
ectropion and they should be drawn tight enough to correct the 
deformity. If left some days they will usually determine cica- 
trices which will overcome the deformity. 

The most common operation (Dieffenbach's) is the excision of 
a triangular portion of skin from just outside the lower lid and 
having its base or upper side running horizontally outward from 
the outer canthus. Then pare the margin of the lower lid for a 
distance equal to the base of the triangle. Then bring together 
and suture the skin forming the right and left sides of the tri- 
angle, and the raw edge of the lid to the skin that formed the 
base of the triangle. In this way the triangular sore formed by 
the operation is completely covered and the margin of the lower 
lid is shortened so as to brace it up against the bulb. 

In case of cicatricial ectropion the Wharton- Jones operation is 
to be adopted. A V-shaped incision is made in the skin of the 
lower lid commencing just beneath the tarsus and carried down 
so that the two lines of incision meet well down beneath the cica- 
trix. The triangular flap of skin thus made, is detached by a 
bistuory from the cicatricial tissue beneath, and allowed to shrink 
upward toward the tarsus. Finally the two edges are sewed to- 
gether from the angle upward, as far as may be necessary to allow 
the proper application of the tarsus against the bulb, and the re- 
mainder of these edges are sutured to those of the triangular flap. 



TUMORS OF THE EYELIDS. 

Warts. The most common tumors of the eyelids in horses, 
cattle, and dogs are warts, These are most simply disposed of 
by seizing them with rat-tooth forceps and clipping them off with 
sharp scissors curved on the flat. Any bleeding may be checked 
by a pencil of silver nitrate. 

Sarcoma, melanoma, and epithelioma are common in soli- 
peds, especially in the gray and white. They usually form a 
cauliflower-like mass red and angry and bleed easily. They 
may occupy any part of the lid, the skin, the dark tarsal margin, 
the connective tissue or the mucosa, and not unfrequently they 
involve the eyeball, and the surrounding tissues, even the bones 
of the orbit. 

Treatment, These may be excised like warts taking care to 
remove every vestige of disease. In these cases I have usually 
found it necessary to remove the entire bulb. Popow cured a 
polypus (probably actinomycosis) by applying tincture of iodine 
daily for four weeks. 



FRACTURE OF THE ORBIT. 

Nature and Causes. The usual seat of fracture is the orbital 
process of the frontal bone, yet any portion of the orbital mar- 
gin may suffer, and even the inner wall or floor of the orbit 
may be broken by a penetrating instrument. Horses and polled 
cattle and sheep are especially exposed to the injury, while in 
horned stock the region is in a measure protected. Carnivora, 
which have no bony orbital process, are less liable but may 
still sustain fractures of the remaining parts. Horses and polled 
ruminants suffer mainly from beating the head on the ground 
or other solid body in the paroxysms of colic and enteritis, or 
in nervous affections ; horned stock suffer from concussions in 
fighting and direct blows by the horns. All animals suffer from 
blows with clubs, kicks and other mechanical injuries. 

Symptoms. With (and less frequently without) a skin wound, 
there may be indication of depression, or mobility of the de- 
350 



Bruises and Wounds of the Orbit, 35 1 

tached segment, or its sharp edge may be felt, through the skin, 
or by the sterilized finger introduced into the orbit. In casd of 
a penetrating or stab wound, which cannot be followed by the 
finger, it may be followed by an aseptic probe and any fracture 
recognized. The conjunctival sac must be first thoroughly 
washed out with an antiseptic lotion, as the introduction of any 
septic germs into the osseous wound is likely to cause a danger- 
ous infection or abscess. 

Treatment, Simple, slight fractures with blunt instruments 
are treated by rest and cooling, disinfectant lotions. If foreign 
bodies or detached particles of bone are found in the wound they 
should be extracted. Shot that are difficult to find, may be left, 
as they are often aseptic and tend to become encapsuled. Should 
they cause abscess they will usually be found in the pus sac and 
may then be removed. Displaced bones may often be replaced 
by the finger in the orbit. Sometimes they can be best reached 
by trephining the frontal or maxillary sinus and introducing a 
lever through the cavity (Hendrickx). If the sinus has been 
involved it must be opened in any case. Cadiot advises bandages 
impregnated with black pitch to fix the bones in certain cases. 
Antiseptic washes (sublimate i : 5000) and antiseptic cotton 
packing are demanded for all wounds. 



BRUISES AND WOUNDS OF THE ORBIT. 

These may come from the same causes as fractures and though 
less violent may occasion inflammation which involves the eye 
or even the brain with fatal results. Thus in horses it has 
been a cause of infective inflammation, with a fatal extension 
(Robellet) ; in cattle a similar inflammation has extended to the 
cerebral meninges and caused death (Leblanc), and in dogs an 
advance to the eyeball threatens its destruction (MoUer). Short 
of this necrosis is not uncommon (Rey). 

Treatment, This does not differ materially from that de- 
manded by penetrating wounds with fracture. A perfect cleans- 
ing and antisepsis of the wound is the first demand. A solution 
of boric acid (4 per cent.) or of mercuric chloride (i : 5000) 



352 Veterinary Medicine, 

liberally applied, and maintained thereafter on soft pledgets of 
surgical cotton, will often have the best results. All foreign 
bodies must be carefully removed, lacerated flaps and shreds may 
require suturing, dead portions excision, and finally abscesses or 
excessive exudate may require the lance, but cooling, antiseptic 
lotions and an elevated position of the head are among the most 
prominent resorts. 



RETRO-BULBAR ABSCESS. 

Schindelka has observed this in the horse, in connection with 
petechial fever. If connected with meningeal abscess it will be 
necessarily fatal. In favorable cases evacuate the pus as soon as 
detected and dress with pledgets of cotton saturated with a mer- 
curic chloride solution ( i : 2000) or other antiseptic. 



PERIOSTITIS OF THE ORBIT. 

This may be shown by the firm swelling of the bone and, in 
case a wound has been formed, by the contact of the probe with 
the denuded, hard, rough bone. When thus exposed or necrosed 
on the surface, or when an exostosis has formed, the bone may 
be laid open and scraped down to the healthy tissue, and then 
dressed with antiseptic pledgets. 



TUMORS OF THE ORBIT. 

These may be of diflFerent kinds, as sarcoma, encephaloid, 
osteoma and actinomycosis. They demand thorough surgical 
treatment, except perhaps in the case of the latter, which may re- 
cover under iodide of potassium. Emmerich records an extensive 
sarcoma of the orbit in a cow, weighing six pounds and extend- 
ing into the nasal sinuses and chambers, and implicating the 
cerebral meninges. MoUer records cases of sarcoma and car- 



Disease of the LcLchrymal Gland and Ducts. 353 

cinoma of the orbit in horses and dogs, and Leblanc in cattle. 
Melano-sarcoma is not uncommon in the orbits of gray horses 
which are changing to white. 

Exostoses are common around the orbits of cattle. 

If such growths do not show on the surface they cause a more 
or less unsightly protrusion of the eyeball, owing to the presence 
of the neoplasm in the depth of the orbit, and the removal of 
the bulb becomes a necessity. 



DISEASE OF THE LACHRYMAL GLAND AND DUCTS. 
DACRYO-ADENITIS. 

Even in man these parts are remarkably free from di.sease, 
while in the lower animals, we have literally no record of such 
conditions. Inflammation of the gland (dacryo-adenitis) would 
be manifested by a sensitive swelling under the outer part of 
the orbital process, and upper eyelid and by lachrymation, and 
obstruction of the gland duct and by a tense transparent rounded 
swelling inside the lid. A fistula is possible from a penetrating 
wound of the lid in the same situation. In both of the latter 
conditions an opening made through the palpebral conjunctiva 
will allow the discharge of the tears in the proper place, and 
healing of any external wound may be hastened by suture or 
plaster. 



OBSTRUCTION OF THE LACHRYMAL PUNCTA. 
ATRESIA. INFLAMMATION. 

Congenital atresia of these puncta has been recorded in foals, by 
HoUmann, and obstruction as the result of inflammation, by La- 
fosse, Verjaus and Tyvaert, and of the entrance of the seeds of 
bronius by Stockfleth. 

Apart from congenital atresia and impaction of foreign bodies 
the symptoms are those of conjuctivitis, with escape of tears 
over the face (epiphora). Injection of aseptic water into the 
23 



354 Veterinary Medicine, 

lower puncta and its escape by the upper, and by the nasal ori- 
fice, will determine the patency or otherwise of the various 
channels. 

Treatment consists in astringent collyria to check the inflam- 
mation, in the removal of any foreign body, in the dilation or 
slitting of the lachrjonal canaliculi, and in case of complete 
atresia, in incising the lachrymal sac. Slitting of the canaliculi is 
accomplished by a small probe-pointed bistuory (canaliculus 
knife). The lid is drawn away from the carnucle, and the probe 
point inserted at first downward, then inward apd backward, and 
when it is well inside the sac the handle is brought to the vertical 
and the walls of the duct slit open. 

In case of atresia Leblanc recommends to seize the inner can- 
thus with rat tooth forceps so as to include the structures about 
the sac and to plunge the bistuory directly into the sac. Then 
by the aid of a whalebone stafiF he passes three silk threads 
through the duct and fixes them in place by attaching them to a 
copper ring at each end. This \s retained in place and moved 
daily until the passage has been definitely healed and its per- 
manency assured. 



WOUND AND FISTULA OF THE LACHRYMAL SAC. 

The lachrymal sac, which receives the tears from the canali- 
culi. is situated in the iufundibulum at the upper end of the 
lachrymal canal and is in great measure protected against exter- 
nal injuries by the prominent orbital edge of the lachrymal bone- 
Yet violent blows with or without fracture, sometimes lead to 
rupture of the mucous walls and the formation of a fistula. 
Wounds made with penetrating bodies, more or less pointed are 
also liable to involve the sac. The fistulous orifice may be through 
the skin at the inner canthus or through the mucosa by the side 
of the caruncle. The cutaneous opening may be a minute orifice 
from which tears and muco-purulent matter escapes, to mat to- 
gether the hairs on the side of the face. Sometimes there is a 
reddish elevation, the size of a pin head, and in fistula through 
the mucosa this is the rule, and the orifice is elevated so that the 



Catarrh of the Lachrymal S(u, Dacryo-Cystitis, 355 

tears flow out over the face. For the symptoms of the attendant 
catarrh of the sac see below. In infected cases with obstruction 
of the lachrymo-nasal duct, it has been known to extend to the 
bone and even to open into the sinuses, or tooth follicles. (Gerard, 
Leblanc). 

The condition is found in horses, cattle and dogs. 

Treatment, In fistula resulting from simple traumatism, noth- 
ing more may be requisite than rest and soothing astringent ap- 
plications. Sutures are sometimes resorted to but are liable to 
cause itching and do more harm than good. It is above all im- 
portant to keep the lachrymo-nasal duct patent, and for this 
purpose a lead or silver stilet, or a thick cat gut suture may be 
worn in the canal until healing has ensued. 



CATARRH OF THE LACHRYMAL SAC. DACRYO- 
CYSTITIS. 

Connected above through the canaliculi with the conjunctiva, 
and below through the lachrjonal duct with the nasal chamber 
this cavity is liable to be more or less implicated in all cases of 
nasal catarrh and conjunctivitis, (strangles, canine distemper, 
influenza). If the lachrymal duct is obstructed so that the tears 
accumulate in the sac, the tendency to catarrh is further en- 
hanced by the distension and weakening of its walls, and by the 
propagation of bacteria which have entered with the tears, and 
find in them a favorable and abundant culture medium ; the di- 
ameter of the sack in the horse being about ^rds. of an inch. 
The presence of foreign bodies is another cause. 

Lesions, Symptoms, Swelling at the inner canthus, which 
raises the caruncle above the normal level, and the escape of tears 
over the lower lid are the most prominent symptoms. If the 
swelling is pressed it subsides, the contents, clear or purulent, es- 
caping through the lachrymal duct, to the nose, or through the 
puncta and accumulating in the inner canthus or flowing over 
the check. The hair beneath the inner canthus is matted to- 
gether, or drops off leaving bare patches. Wolff found in one 



356 Veterinary Medicitie, 

case, a distension of the sac to over two inches in breidth, and 
lYi inches long. To the swelling there is soon added conjunctival 
inflammation, closure of the puncta by swelling and the escape of 
all tears over the face. Suppuration supervenes in the sac, and in 
the larger animals the pent up pus often makes its way outward, 
causing destructive ulceration of the walls of the canaliculi and 
puncta, or of the walls of the sac, the skin, or even the subjacent 
bone. In this way fistula results. Caries of the bone and pene- 
tration of the molar alveoli may ensue. (Girard, Leblanc). 

Treatment, The first object must be to secure a free drainage 
into the nose. The evacuation of the sac by compression having 
been accomplished, an astringent solution may be injected through 
the nasal opening of the lachrymal duct. If the canal is per- 
vious the sac will be re-filled and will swell out as before. The 
injection may be 0.5 per cent, sulphate of zinc, i per cent, ace- 
tate of lead, 0.3 per cent, nitrate of silver, i per cent, tannic 
acid, 2 per cent, boric acid, or 0.02 per cent, corrosive sublimate. 
Cocaine may be added in the proportion of 5 per cent. The in- 
jection may be repeated thrice a day at first, then twice, and 
finally once as the catarrh subsides. Lubke uses aluminate of 
copper. 

If the injection fails to reach the sac, thoroughly sterilized, 
flexible probes may be used daily, increasing the size as they can 
be passed without too great pressure. 

Or the puncta and canaliculi may be injected as in the human 
subject, the conjunctiva having been first anaesthetized by co- 
caine, or general ether or chloroform anaesthesia having been in- 
duced. The slitting of the puncta and canaliculi may be re- 
sorted to, as spoken of under atresia. 

The frequent passage of a sound is usually resorted to, and a 
stilet may even be worn, but there is always danger of resulting 
thickening and narrowing of the duct, and, if healing can be se- 
cured without this measure, it is to be preferred. 



STENOSIS OF THE I^ACHRYMO-NASAL DUCT. 

Obliteration of the lachrymal duct may occur from stricture of 
the canal, the result of wounds or other irritants: from pres- 
sure by the inflamed mucosa in nasal catarrh, or strangles : from 
polypus or osseous tumor in the nose : from actinomycosis or 
other disease of the bones. 

The one manifest symptom is the escape of the tears on to 
the face. To complete the diagnosis, injection of one punctum 
will cause distension of the lachrymal sac. 

Treatment, This may be attempted by bougies. In the horse 
a small sound, metallic or whalebone bougie, thoroughly sterilized 
and smeared with aseptic vaseline, or oil, is inserted from the 
nasal opening and carefully passed on into the sac. In the dog 
the^nasal opening cannot be reached and the bougie must be 
passed by the puncta and lachrymal sac. To secure the requisite 
dilation, it is usually necessary to probe the passage daily, using 
a larger probe when the first passes easily, until the canal has 
been sufficiently dilated. 

A second resort is to distend the canal by a liquid injection 
thrown into the nasal opening. This will succeed when the ob- 
struction is only caused by concretions in the canal. 

A somewhat similar resort is the insufflation of the duct by 
means of a finely pointed tube inserted from below into the nasal 
orifice of the duct. 

Still another method is to make a new opening for the escape 
of the tears into the nose. When the stenosis is at or near the 
nasal opening of the duct, an artificial opening is easily made and 
usually satisfactory. Under anaesthesia, a sterilized silver 
probe is passed through the upper punctum, the sac and 
canal. When it meets definite obstruction its position is ascer- 
tained inside the nose, and an incision is made so as to allow its 
escape. The constant escape of tears tends to prevent it from 
closing up again, but it is well to examine into this until it 
has thoroughly healed. A silk thread worn in the duct and 
held in place by a copper or aluminum ring on each end may be 
resorted to. 
357 



358 Veterinary Medicine, 

Attempts have been made to establish a new outlet by boring 
through the lachrymal bone into the nose, but without a perma- 
nent success. It has also been advised to obliterate the lachrymal 
ducts and sac, on the one hand and to excise the lachynnal 
gland on the other, but the proposed cure is worse than the 
disease. 



DISEASE OF THE LACHRYMAL CARUNCLE. 

The caruncle is inflamed in conjunctivitis. When this inflam- 
mation leads to hypertrophy it is known as encanthis. This is a 
common condition in dogs and the caruncle may increase to the 
size of a pea or acorn, and by compressing the canaliculi it leads 
to a profuse overflow of tears on the cheek. At first there is 
the acute congestion of conjunctivitis, but later there may be in- 
duration and pallor. 

The treatment of this condition consists in astringent and seda- 
tive coUyria in the early inflammatory stages, and later in the 
ablation of the hypertrophied mass. The caruncle is seized with 
a pair of rat-tooth forceps and snipped off with curved scissors^ 
the free bleeding being afterward checked by cold water. 

In cases that seem, by reason of excessive vascularity ill 
adapted to this method, the hypertrophied mass may be tied at 
its base with a stout silk thread so as to cut off the supply of 
blood, and cause it to slough off. A coUyria of boric acid (4 per 
cent.) or mercuric chloride (0.02 per cent.) may be used to 
prevent infection. 

Tumors of the Caruncle are met with, such as fibroma 
(Worz), Sarcoma and Melanosarcoma. For all alike the com- 
plete extirpation of the neoplasm is demanded. 



WOUNDS AND INFLAMMATION OF THE MEMBRANA 

NICTITANS. 

Like other parts of the ooular apparatus, the third eyelid and 
gland of Harder are subject to accidental injuries of various kinds. 
What is worse, ignorant persons seeing the cartilage and mem- 
brane projected over the eye in ophthalmias and tetanus, have 
mistaken it for a morbid product and deliberately cut it off in 
part. The condition of the organ may be ascertained by parting 
the lids with the fingers and pressing gently on the front of the 
eyeball, when the aiictitating membrane will be fully exposed. 

If detached portions cannot be restored, but threaten to slough, 
or cause distortions or unsightly and irritating neoplasms they 
should be seized with forceps and snipped off with scissors. 
Otherwise the treatment consists in soothing astringent and 
anodyne CoUyria as in conjunctivitis. 



TUMORS AND HYPERTROPHY OF THE MEMBRANA 

NICTITANS. 

Papilloma is seen in the dog (Hobday), epithelioma and lipoma 
in the horse (Frohner, Williams), also dermoid (Schimmel). 

Neoplasms of this organ may occur in any quadruped or bird 
and may be recognized by the swelling of more or less of its sub- 
stance, by the unevenness of its free margin, or by distinct out- 
growth from its surface. They are especially common in dogs 
and pigs and may be fibrous, epithelial or otherwise. The treat- 
ment is purely surgical and in case of a malignant neoplasm 
should demand the removal of the entire organ. 



ADENOMA OF THE GLAND OF HARDER. 

Cases in dogs have been recorded by Frohner and Schimmel, 
and it might be expected in other camivora, ruminants, pigs, 
rabbits and birds. The treatment is by excision with forceps 
and scissors, and subsequent treatment with an antiseptic zinc 
lotion. 

359 



360 Veterinary Medicine, 

FOREIGN BODIES IN THE CONJUNCTIVAL SAC. 

Frequency ; seeds, glumes, awns, dust, sand, wood, metal ; exudate ; in 
coniunctival pouch, under nictitans in puncta. Filaria lachrymalis. 
Symptoms : closure of lids, epiphora, congestion, inflammation, infection. 
Treatment : local anaesthesia, forceps, lead pencil, pin*8 head, collyria. 

So common are foreign bodies in the conjunctival sac of the 
domestic herbivora, that in any case of epiphora, hyperaemia or 
inflammation of the mucosa, the first care should be given to see 
that the condition is not caused by the presence of such an irri- 
tant. In animals fed from high racks, seeds and glumes of the 
gramineae, awns of barley, and dust of various kinds often get 
into the eye and stick fast. Under other conditions, insects, 
particles of sand, dust, wood, metal, etc., prove equally injurious 
by their presence. Awns and chaff are particularly liable to ad- 
here to the mucosa and even to become covered by an exudate, 
which renders them more firmly adherent. Other objects lodge 
under the eyelids, or membrana nictitans, or in folds of the mu- 
cosa. Their entrance into the lachrymal puncta has already been 
referred -to. The larger and more rounded bodies are likely to 
be washed oflF by the excessive flow of tears, assisted by the move- 
ments of the nictitating cartilage, but flat glumes, or awns stick 
too closely to the surface, while the smaller objects become en- 
tangled beneath the lids, or hair, or in the folds of the mucous 
membrane. The filaria lachrymalis may be the cause of trouble. 

Symptoms. There is closure or semi -closure of the lids, the 
escape of a profusion of tears over the cheek, and active con- 
gestion or hyperqpmia. A careful examination with everted lids, 
or even with raised nictitans will usually reveal the foreign body. 
If overlooked or neglected the hyperaemia rapidly advances to 
active inflammation, with or without an infective complication. 
Foreign bodies blown into the eye, as a rule carry with them 
more or less bacteria, and, if these have any tendency to patho- 
genesis, the irritation of the mucosa easily paves the way for 
their colonization. Thus, any grade or form of conjunctivitis 
may supervene upon the introduction of a foreign irritant. 

Treatmefit. Nearly all such bodies are most easily and cer- 
tainly removed by a pair of fine forceps. It may be necessary to 
first anaesthetize the eye with a 5 per cent, solution of cocaine. 



Wounds of the Conjunctiva^ 361 

The clean tip of the finger passed under the lid and nictitating 
membrane is a safe and effective method. Less effective methods 
are to pick up the offending body on the point of a lead pencil, or 
a small, blunt metallic spud, or with a pin's head covered with a 
clean pocket handkerchief. This may be followed by an anti- 
septic (boric acid) coUyria, with or without cocaine or morphia. 



WOUNDS OF THE CONJUNCTIVA. 

These occur in all domestic animals, but are especially fre- 
quent in dogs and cats from scratching with the claws. In 
clumsy handling of the eyelids, the mucosa is wounded by ragged 
and uneven nails. Injuries and stings by insects which are at- 
tracted by the reflection from the eye constitute a specially grave 
lesion, often proportionate to the nature of the poison instilled. 

Symptoms, There are usually closure of the eyelids, with 
exudation and thickening of the conjunctiva especially in the 
vicinity of the wound, a free flow of tears, mingled it may be 
with blood, and the visible evidence of the lesion on the exposure 
of the injured part. If the cornea is implicated, even the pupil 
is contracted, showing photophobia. 

Treatment. Slight noninfected wounds will heal readily under 
simple astringent collyria, following upon the removal of any 
cause of mechanical irritation. A solution of corrosive sublimate, 
I : 5000, or of boric acid, 4 per cent, may be used. If photopho- 
bia exists Yt, per cent, of atropia sulphate or i per cent, of cocaine 
hydrochlorate will usually give relief. Extensive wounds may 
require sutures, and sloughing tissue may be excised with fine 
curved scissors. Excessive granulations may be removed in the 
same way. For stings use a potassium permanganate solution 
(2 grs. to I oz). Violent inflammation may be met by a laxative 
and by leeching the periorbital region. 



BURNS OF THE CONJUNCTIVA. 

Bums and cauterizations may occur in all domestic animals 
from acids, alkalies, quicklime, carbolic acid, boiling liquids, etc. 
The cornea usually suffers, being the part most exposed. The 
caustics cause swelling, blanching and finally exfoliation of the 
epithelium, or even of the superficial layers of the cornea. In 
burns by hot liquids vesication may be present. If the destruc- 
tion extends deeply into the cornea there may be escape of the 
aqueous humor and destruction of vision. If less penetrating, 
there may still develop vascularity, and permanent opacity by 
reason of the formation of a cicatrix or a change of structure in 
the layers of the cornea, or, in dogs especially, adhesion of the 
cornea to the eyelids (symblepharon). In the early stages there 
is closure of the eyelids, with swelling, profuse lachrymation, 
and photophobia. 

Treatment, The first object is to remove or neutralize the 
offending body. Thus sulphuric or other mineral acid would 
demand a free irrigation with a i per cent, solution of carbonate 
of soda or potash. For alkalies, carbonated water, or a 4 per 
cent, solution of boric acid may be employed. For lime, Gosselin 
recommends free irrigation with saccharated water. The first 
step, however, should be to wipe out the particles of lime with 
a soft rag soaked in oil. 

The pain may be met by a solution of cocaine ( i per cent. ) , 
or atropia ^ per cent. In addition, we may irrigate with cold 
water or apply weak antiseptic coUyria, and employ derivation 
by the bowels or the skin. 



SIMPLE ACUTE CATARRHAL CONJUNCTIVITIS. 

Causes: irritant gases, smoke, dry air, dust, pollen, microbes, insects, 
seeds, chaff, awns, sand, dust, quicklime, coal dust, hairs, whips, canes, 
branches, stubble, fences, nails, claws, teeth, iodine, chlorine, bromine, 
formalin, turpentine, rain, hail, sleet, glare of sun, ice, snow, white sand or 
clay, filaria, acari, infectious diseases. Symptoms : closed, lids, epiphora, 
redness diffuse on lids, ramified on sclera, projected nictitans, milky floc- 
culent discharge, later purulent, matted lashes or tarsi. No photophobia. 
362 



Acute Catarrhal Conjunctivitis. 363 

Pever variable. Lesions : ezadate : cell proliferation : papills enlarged : 
desquamation : swollen lymphoid bodies : hyperplasia : abscess : ulc^r. 
Treatment : remove cause, sterilized syringing, antiseptic and astringent 
collyria, sublimate, zinc sulphate, lead acetate, pyoktanin, silver nitrate, 
morphia, atropia, cocaine, vaseline, cupping, leeching. 

Under thisrhead may be noted the simple forms of conjuncti- 
val inflammation, which result from direct injuries, irritant 
gases from manure, smoke, very dry air, dust, pollen, and 
in which no specific nor contagious element is a prominent 
feature. Strictly speaking, all purulent conjunctivitis are prob- 
ably infecting, as all may be held to be associated with the 
presence of pus microbes. As early as 1864, de Graefe 
said every inflammation of the conjunctiva which ''secretes, 
is inoculable and therefore transmissible," and Warlomont con- 
curs, saying that ' ' conjunctival ophthalmias have one character in 
common : all can produce a secretory product which, when brought 
in contact with a sound conjunctiva, is capable of proVoking 
the different affections of this mucosa.*' The exposure of the 
conjunctiva of man and beast alike, to the germs borne on the dust 
or carried in liquids or on solids, renders this structure preemi- 
nently susceptibile to infection, while the lachrymal and mucous 
secretions furnish a favorable culture medium. Fortunately in 
the lower animal the danger of infection is greatly reduced, since 
there are comparatively few opportunities for the transference of 
the germ through water, soap, sponge or towel, to which man is 
exposed, not only in public lavatories but even in private families. 
Thus in the animal the single case remains isolated and in a 
sense sporadic, only because there have not been the means of 
transferring and inoculating the morbid product. 

Causes. The contact of mechanical and chemical irritants of 
all kinds, insects, seeds of gramineae, chaff, particles of fodders, 
barley and other awns and spikes, grains of sand, dust, quick- 
lime, coal dust, smoke, hairs, blows with whips, canes, branches, 
stubble, fences, etc. Also erosions caused by nails, claws, teeth, 
and by falls must be considered. 

Irritant gases and vapors whether from accumulation of 
manure in the stables, or from chemical products of fires and 
factories are direct causes. The mere exposure for sometime 
to the warm, dry air from a furnace is injurious to the mucosa. 



364 Veterinary Medicine, 

and the emanations from certain medicines, iodine, chlorine, 
bromine, formaline, turpentine are strongly irritant. 

Exposure in a cold draught, or in a blast of cold rain or hail, 
or even to a cold dry wind, in the case of hunting dogs working 
much in water, are potent factors. 

The glare of the sun through a window at the front of a 
stall, or from a white surface of snow, ice or water or even from 
white sand, lime or clay is an active cause. The overdraw check 
exposing the eyes directly to the sun is often injurious. We 
must include the irritations caused by the filaria lachrymalis and 
by various lesions already described — trichiasis, entropion, ectro- 
pion, stenosis of the lachrymal duct, etc. 

In certain animals a distinct predisposition exists, often as the 
result of a previous attack, and such are readily attacked under 
slight disturbing causes. 

It should not be forgotten that hyperaemia and even inflam- 
matioii of the conjunctiva, often accompanies diflFerent infective 
diseases — strangles, influenza, contagious pneumonia, rinderpest, 
canine distemper, etc. 

Symptoms, The discharge of tears and the closure more or 
less complete of the eyelids are among the earliest and most 
marked symptoms. The general conjunctiva is congested and 
that on the inner side of the lids especially, so as often to 
hide the individual vessels, while on the sclerotic portion they 
usually remain distinct, tortuous and freely movable with the 
mucosa upon the sclera beneath. The membrane is more or less 
infiltrated, swollen and opaque. In two or three days this has 
increased so that the lids are visibly swollen, and completely 
closed, or the paw is projected over the cornea. The discharge 
has become milky or flocculent, and mats the cilia together, or 
holds the eyelids closed. Unless the cornea has been directly 
injured it usually remains clear, and there is no photophobia 
nor contraction of the pupil. The lids, however, are tender and 
nervous animals show active resistance to any attempt to ex- 
amine the eye. In aggravated cases a free muco-purulent dis- 
charge takes place, and the red, swollen mucosa projects 
between the eye and the tarsus, constituting chemosis. In such 
circumstances the inflammation may extend to the cornea causing 
opacity and photophobia or to the iris and • choroid or other 
deep-seated parts. 



Acute Catarrhal Conjunctivitis, 365 

In the milder forms of the affection there may be little or no 
hyperthermia, while in severe attacks the febrile reaction may be 
considerable. 

Lesions, The non- traumatic cases which are not complicated 
by varied wounds and injuries, show exudation and cell prolifer- 
ation in the palpebral conjunctiva and to a less extent in the bul- 
bar. The conjunctival papillae are swollen and become visible to 
the naked eye and in aggravated cases stand' out like fungous 
masses. The superficial layer of cylindroid epithelium is found 
swollen, opaque and sometimes desquamating. The lymphoid 
bodies which are most abundant in the depth of the conjunctival 
sac, are infiltrated, swollen, and bulging in reddened masses. 

Other lesions in the nature of granular or follicular hyper- 
plasia, abscess and corneal new growth and ulcers may follow, 
but will be better considered under separate headings. 

The tendency of simple uncomplicated conjunctivitis is to re- 
covery which may be completed in a week or ten days. In case 
of contused wounds, abscess, ulcer, special infection in a lym- 
phatic subject like the ox, the aflFection is more likely to be 
prolonged or followed by grave lesions. 

Treatment, The first object must be to remove the cause, 
hence foreign bodies, displaced lids or cilia, irritant gases, excess 
of light, cold draughts or exposure, etc. , must be sought and 
corrected. For the removal of the foreign bodies, fine forceps or 
various common articles (hair pin, lead pencil, a pin head, a 
folded clean handkerchief, or even the clean finger) may be used. 
In case of wounds especially, they should be first sterilized. 
Boiled water which has been cooled to luke warm may be used 
from a sterilized syringe. 

Locally antiseptic and astringent colly ria (sublimate solution — 
I : 5000, zinc sulphate — i : 1000), lead acetate, alum, tannin, 
creolin, boric acid, tannoform, formalin, itrol, colargolum, silver 
nitrate, etc., are valuable and may even be thrown under the 
eyelids from a syringe with a finely rounded nozzle and many 
orifices. Even a 2 per cent, solution of silver nitrate may be ap- 
plied in the conjunctival sac twice daily, or as being less irritating, 
a solution of pyoktanin (i : 1000). If the irritation is great a 
soft rag wet with the solution may be attached to the headstall 
of the bridle and hung loosely over the eye, care being taken to 



366 . Veterinary Medicine. 

prevent drying. A few grains of morphia added to the coUyria 
will be specially soothing. Irrigation of the eyelids or bathing 
for ten or fifteen minutes at a time with luke warm water, will 
often greatly relieve. When the eyelids become agglutinated 
during sleep or prolonged closure, as in the small animals, cleanse 
with a tepid sublimate solution, and smear with vaseline. In 
severe cases local depletion may be resorted to. The hair may 
be shaved off from an area of 2 inches below the orbit, and a cup 
applied for ten minutes. Scarification may or may not be re- 
sorted to. Or a leech may be applied to the same part. 

A laxative often proves an excellent derivative especially use- 
ful in costive conditions. 



CHRONIC CONJUNCTIVITIS. 

Sequel of acute. Same causes. Old horses, young foals, damp lands, 
night dews, frosts, eczema, follicular scabies. Lesions : swelling of lymph 
bodies in conjunctival poucb, general congestion, cheniosis, bypertrophied 
papillae, clouded cornea; Symptoms : as in acute form but less intense. 
Treatment : Remove cause, irritants, damp soils, stables, etc., glare of 
ligbt, beat, etc., astringent antiseptic lotions, atropia, mercury oxide, coun- 
ter-irritation, setoning, cupping, leeching. 

This is generally recognized by veterinary writers as a sequel 
of the acute form, though it may begin de novo, from slight per- 
sistent causes of irritation. Habitual exposure to fierce light, dusty 
roads, ammoniacal and other gaseous emanations, and at other 
times to the dust from musty fodders in a high rack, trichiasis, 
entropion, ectropion, and indeed any continued irritation may 
start the disease or keep it up. Leblanc says it is especially 
common in old horses and young foals pastured on low damp 
grounds, bottom lands and lake shores, and in worn out work 
oxen which have been exposed to cold night dews, or frosts. In 
this respect it resembles the recurring ophthalmia of the horse 
which prevailsespecially in lymphatic subjects. In dogs, Leclainche 
has observed it associated with eczema or follicular scabies of 
the lids. 

Lesions, Besides the general congestion of the mucosa, there 
are liable to be special lesions in the depth of the conjunctival sac 
at the point where the mucosa passes from the eyelid to the scler- 



Chronic Conjunctivitis, 367 

otic, causing uneven swellings from infiltration in this region. 
The l3rmph bodies or follicles in this part are swollen and project 
as small red or grayish nodules visible when the eyelid is everted, 
and at other times the whole infiltrated conjunctiva projects be- 
tween the lids constituting the condition known as chemosis. 
The papillae conjunctivae are also hypertrophied, so as to become 
visible to the naked eye, and ulcers may be present on the mu- 
cosa. The cornea is often clouded blue or milky, or it may have 
become in part vascular and reddish, or even ulcerated. A more 
or less abundant muco-purulent discharge is always present. 

Symptoms, The inflammation is usually moderate in degree, 
the eyes water without being habitually closed, the hairs are lost 
from the cheek, which is habitually wet, the lids are swollen, and 
like the cilia tend to stick together after sleep, and the whole 
mucosa is visibly infiltrated and congested, but usually especially 
at given points, as in the cut de saCy on the lids or membrana 
nictitans. Unless the animal has been treated with irritant 
dressings, there is much less pain on manipulation than in acute 
conjunctivitis. On everting the lids the folliculitis in the cut de 
sac and the circumscribed swellings become apparent. The 
membrana nictitans is partly projected over the cornea, and the 
eyeball usually appears smaller by reason of its retraction within 
the orbit. 

In cases of eczema, or demodectic mange, the lesions of the 
skin of the eyelids will furnish the key to the trouble. 

Treatment, The first object must be to remove the cause 
which tends to keep up the malady. Foreign bodies, musty hay 
fed from high racks, dusty roads, excess of light, windows in 
unsuitable places, damp stalls or pastures, and local parasitism 
must be corrected. In case of persistent chemosis keeping up 
the inflammation, and which will not subside under the usual 
astringent lotions, the hernial mucosa may be excised. (See 
chemosis. ) 

The usual astringent lotions may be employed, sulphate of zinc 
(2 : 100), sulphate of copper (i :2oo), alum (5 : 100), tannin 
(10 : 100) to which may be added sulphate of atropia. In place 
of being simply applied to the surface of the lids, or the cornea, 
it is usually desirable to inject it into all parts of the cul de sac 
beneath the upper and lower lids and beneath the nictitating 



368 Veterinary Medicine. 

membrane. Alum 4 grs. and boric acid 3 grains, in water i oz. 
make a good combination. As the mucosa becomes accustomed 
to one agent, we may change for another. Thus in addition to 
the above, silver nitrate (2 : 100), and lead acetate (2 : 100) are 
often useful as alternates. In obstinate cases red or yellow 
oxide of mercury in vaselin (5 : 100) may be applied inside the 
lids and on their margins. 

Counter-irritation is often desirable, in the horse a blister of 
cantharides or mercury biniodide to cover a spot as large as a 
silver dollar above the anterior end of the maxillary spine 
(zygomatic), or a stout silk thread as a seton inserted in the same 
place. In the dog the blister may be applied on the temporal 
region. 

Cupping or leeching beneath the eye, or phlebotomy from the 
angular vein of the eye may prove useful. Great care should be 
taken to prevent further injury by rubbing. 



PURULENT CONJUNCTIVITIS. BLENNORRHGBA. 

More pnmlent and more infective through dnst, tongues, rubbinf( posts, 
kennels, swill ; a class due to different microbes. Prevalence in dogs, 
swine, horses, sbeep, goats, cats. Symptoms: acute conjunctivitis with 
excess of pus, follicular swelling and enlarged lymph bodies in cnl de sac 
Diagnosis. Treatment : Astringent and antiseptic lotions, injected often : 
silver nitrate : pyoktanin. 

The forms of conjunctivitis in which there is an abundant pro- 
duction of pus are usually relatively more inoculable and there- 
fore more liable to pass from animal to animal in a casual manner. 
Infection takes place through the dried up discharges floating as 
dust, but more directly by means of the tongue when the animals 
lick each other, and through posts against which they rub the 
head. Animals smelling or licking the infected genital organs 
and then the eyes of their fellows may convey it readily. Dogs 
occupying the same kennel successively, contract the disease 
(Guilmot). Swine feeding from the same trough and plunging^ 
the face into swill up to the eyes are especially subject to infec- 
tion. In speaking of such infections one must be understood to 
refer to a group and not to a specific disease, as that will vary 



Purulent Conjunctivitis, Blennorrhcea, 369 

with the particular pus microbe present, and with the virulency 
of such microbe in the particular case. In keeping with the 
greater fertility of microbes in -the warm season, these affections 
have been more commonly met with in summer than in winter, 
and where the animals are kept in filthy surroundings rather than 
otherwise. This is above all true of swine. Moller records a 
wide spread epizootic of gonorrhoeal ophthalmia in dogs in Berlin 
and environs in 1883. In different cases, however, he failed to 
induce disease in the eyes by direct inoculation with the preputial 
secretion. Heinman equally failed with the gonococcus of man 
in inoculations on the eyes of rabbits, and dogs. Frohner, how- 
ever, succeeded in infecting the eye of the dog by applying the 
gonorrhoeal discharge of man. 

Infecting inoculable, purulent ophthalmia has been reported 
in the horse (Vermast, Sobornow, Blazekowic, Menard, Moller, 
Leclainche), in sheep (Repiquet), and in goats (Mathieu). 
Again Blazekowic found in an infectious ophthalmia of horses, 
dogs and cats a microbe which was like that of malignant oedema. 

The symptoms are those of conjunctivitis with especially free 
production of pus, and a tendency to chemosis or to follicular in- 
flammation in the depth of the conjunctival sac, with irregular 
swellings of the lymph bodies. The pus accummulates in the 
inner canthus, inside the lids and along their margins, and tends 
to mat them together. The diagnosis depends on the rapidity 
and severity of the course of the malady, on the depth of the con- 
gestion and on the profuse suppuration. 

Treatment. Astringent and antiseptic lotions are especially 
indicated. Mercuric chloride (i : 5000), boric acid (2 : 100), 
creolin (i : 100), salicylic acid (i : 1000), silver nitrate (i : 200), 
It is not, however, enough that these should be applied externally ; 
they should be freely injected under the lids at all points so as to 
act on the deepest portions of the conjunctiva, and this should be 
repeated once or twice daily. Or they may be applied with a soft 
brush. In a specially virulent outbreak silver nitrate (2 : 100) 
or pyoktannin (i : 1000) solution may be used. Setons and 
blisters, laxatives and cooling diuretics may be employed as in 
the severe types of simple conjunctivitis. 
24 



370 Veterinary Medicine. 

INFECTIOUS CONJUNCTIVITIS IN HERBIVORA. 
ENZOOTIC OPHTHALMIA. 

Causes: infection, pollen, soil emanation, winter or summer; cases of 
extension by infection. Cattle, sheep, goats, ponies. Accessory irritants. 
Symptoms : severe purulent conjunctivitis. Papillary and follicular hyper- 
trophy « uniform redness, protruding head, opacities, erosions, ulcers, pho- 
tophobia, staphyloma. Treatment : rest, darkness, coolness, elevated head, 
purgative, diuretics, sedatives ; locally solution of pyoktanin, sublimate, 
silver nitrate, boric or salicylic acid, atropia, puncture. 

Causes, This affection which attacks at once or in rapid suc- 
cession a large portion or the whole of a herd or flock, is by many 
held to be infectious while others attribute it to irritant pollen 
or soil emanation. Its origin from vegetation in flower is held 
to be supported by its greater frequency in summer than in 
winter, and the few outbreaks seen in winter are attributed to 
pollen preserved in the hay. But other things being equal, 
organized germs are preserved, multiplied and diffused to a 
greater extent in the hot season so that the origin of the dis- 
ease from a purely microbian source is at least equally plausible. 
Certain outbreaks indeed show the transmission of the infection 
in a most unequivocal manner. A cow suffering from the 
affection was brought into a stable occupied by a herd previously 
sound, and in a few days the cow standing next her was attacked, 
and thereafter a number of others in rapid succession. A small 
number of cattle from the Buffalo Stock Yards, but which had 
sore eyes on their arrival in Tompkins Co., N. Y., were placed in 
a sound herd and the disease spread rapidly to the other members 
of the herd. Similarly in both sheep and cattle the writer has seen 
the disease prevail in one herd or flock, while the adjacent herd 
or flock, separated only by a good stone wall and subject to ex- 
actly the same condition of soil, water, exposure, vegetation and 
pollen has entirely escaped. Kayser has seen it introduced into 
a herd by a bull ; Fiinfstiick saw a herd of 300 head attacked in 
a few days, and Klink 20 out of a herd of 40 head in 14 
days. Trumbower has never seen an animal suffer a second 
time. This is the common experience and would suggest an 
acquired immunity, yet the comparative rarity of the disease for- 
bids a positive conclusion, without further experience. Menard 
saw an outbreak among the ponies in the Jardin d* Acclimatation, 



Infectious ConjuncHvitis in Herbivora, 371 

and as many as fourteen weeks later in the same gardens it at- 
tacked the bovine animals. 

In sustaining the doctrine of infection, however, we must not 
altogether ignore accessory causes. Like other affections of the 
eye, this has seemed to appear especially in low, damp lands, 
bottom lands, deltas, marshy borders of lakes and level prairies, 
so that a general lack of tone or a lymphatic constitution may be 
held to predispose. Nor is it necessary to ignore the influence 
of pollen, dust and other irritants, which though they may not 
cause the specific disease, yet prepare the way for its attack by 
reducing the resisting power of the tissues. 

Symptoms, These are the phenomena of severe purulent con- 
junctivitis. Closed eyes ; profuse secretion of tears, sometimes 
mixed with blood, changing in a few days to a thick, purulent, 
w^ite or yellow secretion, which collects in masses inside the lids, 
along their margins, in the inner canthus and on the cheeks, 
gluing together the cilia, lids and hairs. When separated the 
lids show a mucosa of an uniform deep red, covered with pus, 
and irregularly swollen according to the amount of infiltration. 
Papillary and follicular h)rpertrophy are marked features, and 
the nictitans projects excessively over the eyeball. In many 
cases the cornea becomes opaque and in some instances erosions 
occur which may cause perforation or loss of the eye. In other 
instances the ulcers heal with the formation of cicatrices, or the 
weakened portion of the membrane yields under the internal 
tension and staphyloma supervenes. In such cases the pupils 
are contracted. 

The disease is usually attended by marked h)rperthermia, the 
secretions, including the lacteal, are materially decreased, appe- 
tite and rumination are impaired and the animal leaves the flock 
or herd. The disease affects cattle and sheep, and Menard, Ma- 
thieu and Hoffmann add horses and goats. 

Treatment, This must be primarily antiseptic, but without 
neglecting constitutional disorder. Rest in a dark, cool stall, 
with the head elevated by tying to a high point. Give at once 
an active purgative i)^lb. Glauber salts in 4 quarts warm water, 
and follow up with cooling diuretics and sedatives (saltpeter % 
oz. and tincture of aconite 20 drops, thrice a day). If the tem- 
perature runs very high a few doses of acetanilid or phenacetin 
may be given. Locally use silver or other antiseptic coUyrium 



372 Veterinary Medicine, 

Locally use pyoktannin solution (i : looo) or mercuric chloride 
(i : 5000) injecting under the lids so as to bring it in contact 
with the whole diseased surface. A cloth wet with the same solu- 
tion may be hung over the eye. Boric acid (i : 100), salicylic 
acid (i: 1000), or silver nitrate (i : 100) may be substituted for 
the above when they seem to be losing their eflScacy. 

Ulcers are treated by pyoktannin or silver nitrate solution ap- 
plied daily with a soft brush. Keratitis will demand atropia. 
Abnormal tension or staphyloma will demand puncture of the 
cornea. Improvement may be expected in a few days and re- 
covery in a week or ten days. 



VARIOLOUS CONJUNCTIVITIS. 

In cow pox, horse pox, and above" all sheep pox, the infec- 
tion sometimes falls on the conjunctiva, giving rise to the for- 
mation of the specific eruption on that membrane. The co- 
existent eruption on other parts of the body (udder, heels, 
hairy portions of skin) of the specific variolous eruption, fur- 
nishes the means of a satisfactory diagnosis. The lesions in 
the eye develop rapidly to an extreme severity. The lids are 
swollen and closed, lachrymation abundant, and early mixed 
with pus, and when exposed the conjunctiva is strongly con- 
gested with circumscribed areas of elevation. In cow pox these 
are circular in form, raised above the surrounding mucosa, 
having a deep red areola and a paler, flattened center. In sheep 
pox the elevations have the same general character, but are liable 
to be more numerous and confluent, and tend to permanent 
opacities, cicatrices, and perforations of the cornea with loss of 
the eye. Short of perforation, internal inflammations are not un- 
common. 

Treatment. At the outset this form may be aborted by the 
application of silver nitrate solution (2 : 100) or sodium h5rposul- 
phite (i>^ : 100). Otherwise the local treatment is like that for 
simple conjunctivitis, cooling astringent and sedative lotions, and 
if need be, derivatives and eliminants. 



APHTHOUS CONJUNCTIVITIS. PHLYCTENULAR 
CONJUNCTIVITIS. 

Closely allied to the last, are those cases in which vesicles ap- 
pear on the conjunctiva. In exceptional cases these are seen 
during an epizootic of foot and mouth disease, while in other 
instances they are associated with eczematous eruptions on other 
parts of the body, particularly in dogs. In the human subject 
conjunctival vesicles are often associated with tuberculosis, but 
this has not been recorded of animals so far. The disease 
usually makes a rapid eruption, with symptoms of extreme in- 
flammation, and its duration is largely determined by the general 
disease. 

Beside the local treatment by astringent or antiseptic and sedative 
coll3rria it may be desirable to correct the hepatic, digestive or 
other disorder on which the eczema depends, or to improve the 
general health by a course of bitters or even of cod-liver oil. 



DIPHTHERITIC CONJUNCTIVITIS IN BIRDS. 

Hens, ducks, pigeons. Local inflammation, fibrinous exudate, concreting 
or becoming cheesy, necrotic, sloughy. Beneath the mucosa red, raw ; 
without epithelium, but excess of lymphoid cells, some only mnco-purulent, 
gravity varies. Grave cases inoculable on birds, mice, rats and rabbits. 
Bacillus diphtherias avium, morphology and biology. Pathogenesis. Pre- 
vention : exclude germ ; cleanliness ; pure air ; pure food ; pure water. 
Quarantine strange fowls, keep flocks apart, seclude manure, segregate 
sick, disinfect. Treatment : Antiseptics ; boric acid ; sublimate ; ichthyol ; 
silver nitrate. Infection to man. 

A disease of the mouth, fauces, nose and eyes, associated with 
the formation of false membranes, has been long recognized in 
birds (hens, ducks, pigeons, etc.), and is known to bird-fanciers 
by the names of roup, and diphtheria. The disease is character- 
ized by the presence of a local inflammation in patches, associated 
in the early stages, with a free serous discharge, but, later, with 
the formation of white, or grayish, fibrinous exudate, which may 
be at first firm and smooth, later soft and cheese like, and still 
373 



374 Veterinary Medicine. 

later in many cases more or less necrotic and sloughing. In Dr. 
Moore's experience this is more common on the conjunctiva 
than on the nares or fauces. The interior of the eye was not in- 
volved in the inflammation. Beneath the false membrane the 
mucosa was devoid of epithelium and the underlying tissue was 
red, raw and angry, bleeding readily when handled, and infiltrated 
with an excess of lymphoid cells. 

The lesions, however, were by no means constant. In some 
even of the fatal cases, the exudate was merely muco-purulent, 
while in others the false membrane was quite abundant. 

The gravity of the affection also varies in different outbreaks 
or in the same outbreak at different times. Sometimes it runs a 
very rapid and fatal course, while at others it becomes chronic 
and comparatively dormant and the great majority recover. 

In its more virulent form it is readily inoculable on birds, mice, 
rats, and rabbits, while the milder cases are not easily propagated 
in this way. 

The false membrane contains a variety of saprophytes, and 
among them the pathogenic bacillus, which may be obtained in 
pure culture by inoculating it on a rabbit or mouse. Emmerich 
believed this bacillus to be identical with the Klebs-Loffler bacillus 
of diphtheria in man, but Loffler recognizes it as essentially 
distinct. 

The bacillus diphtheruB avium is 0.8 to 1.5/1 long, by 0.8 to 
1.2/1 broad. The ends are oval so that short specimens seem 
round. In bouillon cultures they form chains or clumps. They 
stain in aniline dyes, most deeply at the poles. Are not stained 
by Gram's method. They are non-motile, aerobic, grow in agar, 
and alkaline bouillon, but render the latter acid in one or two 
days. Do not grow on peptone gelatine, nor produce gas with 
sugars. Are killed in 5 minutes at 58** C. (137° F.). Are killed 
by dryness in 24 hours, by sulphuric acid (0.25:100) in 10 
minutes, by lime water in i minute, and by sulphur fumes. 

Pathogenesis. Eight rabbits inoculated subcutaneously with 
o.i cc. of the bouillon culture died in 18 to 36 hours. Of several 
white and gray mice inoculated only one died. Inoculations of 
mature hens subcutem and on the nose had no effect. Inocula- 
tion of a six weeks old chicken caused death in 4 days with ba. 
cilli in the liver and blood (Moore). Inoculation of pigeons pro- 



Diphtheritic ConjunctiTntis in Birds, 375 

duced the disease (Loffler). It seems doubtful whether the 
milder forms part with their virulence to birds, when cultivated 
artificially, or whether a special susceptibility is required in order 
to render the inoculation eflFective. 

Prevention. Besides the general conditions of good hygiene, 
cleanliness, pure air, and pure water, the strict exclusion of the 
germ is the great desideratum. New fowls should not be taken 
into a flock, when they show any indication of disease in the 
mouth, throat, nose or eyes, nor when they come from a flock in 
which such signs of disease can be found. When examination 
of the flock, from which they are sold, cannot be made, the new 
fowls should be placed by themselves in quarantine until proved 
sound. Sound flocks should not be allowed to wander at large 
and mingle with the birds that are unsound, or open to sus- 
picion. Neither should they be allowed to come in contact with 
manure from suspected poultry yards. If disease of air passages, 
mouth or eyes appears, separate at once the diseased fowl, and 
sprinkle roost, house and yard with dilute sulphuric acid, quick- 
lime, or other disinfectant. 

Treatment, Beside separation and disinfection the local use 
of antiseptics to the surface divested of the false membrane gives 
the best promise. Boric acid solution (4 : 100) or sublimate 
solution ( I : 5000) may be applied to the eye. For the nose and 
mouth somewhat stronger applications may be made. 

Prevention of infection to man. The essential difference of the 
Klebs-Loffler bacillus of diphtheria in man, and the microbe of 
this affection in fowls does not exclude the necessity of avoiding 
contagion from birds to man. Among reported cases of such in- 
fection are: (i) That at Wesselhausen, where 4 attendants on 
the fowls contracted the disease from the sick fowls at a time 
when no other cases existed in the human population : (2) That 
of Sebdon where 6 persons suffered and 10 fowls fed by a hospital 
attendant also suffered : (3) That of Tunnis in which diphtheria 
prevailed in fowls, and soon also in those who fed them pro- 
ducing an extended epidemic : (4) That of Jacksonville, 111., 
where a diphtheritic chicken, conveyed the disease, with fatal 
effect, to a child which fondled it (Moore). 

These and other similar instances seem to show that the disease 
of the bird may become so virulent as to be communicated to 



376 Veterinary Medicine. 

man, and the disease of man so potent as to be transmissible to 
the bird. Every precaution therefore should be taken to prevent 
infection passing from one to the other. 



FOLLICULAR CONJUNCTIVITIS. 

Common in dogs. Violent congestion with enlargement of lymph fol- 
licles, or beneath the nictitans, dark red, like millet seed, also over sclera 
and lids. Enlarged lymph follicles with excess of lymphoid cells. Often 
chronic. Entropion. Infection. Treatment : astringent and antiseptic 
lotions : lunar caustic : cocaine and crushing of follicles : pure air : excision 
of nictitans 

Frohner has drawn attention to the frequency of this a£Pection 
in the dog, which according to him attacks 40 per cent, of the 
race. It is especially liable to begin on the inner surface of the 
membrana nictitans, and though it may be at first somewhat 
hidden by the severe congestion, yet when that subsides in part, 
the swollen follicles can be seen as dark red elevations, the 
size of a millet seed, when the nictitans has been everted. It 
may extend over the sclerotic and palpebrae. Microscopically 
these swellings are found to be enlarged lymph follicles, with 
an excess of lymphoid cells. 

The disease tends to assume a chronic course and may cause 
entropion and other troublesome lesions. The diagnosis depends 
on the recognition of the swollen follicles, and especially in the 
depth of the conjunctival sac. 

It is presumably infective yet all Frohner' s inoculation gave 
negative results. 

Treatment. In the earlier stages the common astringent and anti- 
septic lotions may be used. Sublimate, or boric acid lotions are 
especially valuable for their antiseptic properties. Should these 
fail, the eyelid and nictitans may be inverted and the individual 
follicles touched with a fine pencil of lunar caustic, the resulting 
smarting being lessened by application of cold water. Incase 
they should still prove obstinate, the conjunctiva may be co- 
cainized and the follicles individually crushed with ciliary forceps. 
Pure out door air is a prime essential in the treatment. 

In extreme cases Frohner counsels the excision of the mem- 
brana nictitans. 



NEOPLASMS OF THE CONJUNCTIVA. 

Pinquecala : fatty growth : lipoma : Melanoma : Dermoid tumor in 
young dogs, calves, sheep. Cocainize the part and excise. Cold water : 
silver nitrate. Polypus. Pterygium. 

A pale fatty looking elevation on the sclerotic at the inner side 
of the cornea is not unknown in the dog, resembling pinquecula 
of man. It has not been seen to prove harmful and may be 
safely ignored. 

Lipoma has also been observed (Miiller) and when trouble- 
some may be removed by excision with scissors. 

Melanosis is met with in gray horses in connection with the 
same disease of the skin of the lids, and usually with generalized 
pigment tumors. In the latter case surgical interference is use- 
less unless it is to secure a very temporary relief. 

Dermoid Tumor of the Conjunctiva. This consists in a 
cutaneous product, consisting externally of a mass of epidermic 
cells, beneath which are connective tissue, fat cells, and muscular 
fibres, glands and growing hairs. It usually extends inward from 
the outer portion of the sclerotic conjunctiva and may encroach 
on that of the cornea. It is firmly adherent to the sclera, and 
sometimes to the cornea by its base and deeper aspect, but the 
apex is free and more or less projecting. The color is yellow, or 
more or less blackened by pigment or even reddened by blood. 

It has been observed, above all, in dogs, Prince reports a case in 
a calf and Zundel in a sheep. The Cornell Veterinary College 
clinic has furnished cases in ox and dog. They have, however, 
nearly always been seen in young animals and are probably 
congenital. 

These are easily removed from the eye anaesthetized by a 4 per 
cent, solution of chloride of cocaine. The inner projecting end 
of the tumor is seized by rat-tooth forceps, and carefully snipped 
off with sharp scissors curved on the flat. Where adherent to 
the cornea it must be carefully handled, but where attached to 
the thicker and more resistant sclerotic it can be dealt with more 
freely. A pencil of silver nitrate may be used to check the 
bleeding, or that may be effected by cold water freely applied. 

Polypus, a small, pale, pediculated tumor of the conjunctiva 
is described by Lafosse and should be removed by scissors, and 
bleeding checked by cold, wet applications. 
377 



PTERYGIUM. 

This name is employed to designate a triangular conjunctival 
fold broader at its sclerotic end and gradually narrowing to its 
corneal extremity, with loose, slightly overlapping borders, and 
firmly fixed to the structures beneath. It is more vascular than 
the surrounding conjunctiva, and its comparatively large blood- 
vessels have suggested the veins of an insect's wing — hence its 
name. The growth may extend from either canthus toward or 
partly over, the cornea. 

MoUer and Leclainche claim its existence in dogs, though 
rarely to such an extent as to demand surgical interference. 
Dunewald operated on a case in the cow. 

Unless growing, it need not be interfered with. It may be dis- 
sected up with scissors, the narrow end being dragged on by for- 
ceps. Another method is to cauterize the narrow end with the elec- 
tric cautery which leads to material contraction of the entire mass. 



XEROSIS CORNEiE (EPITHEUALIS). DRY KERATITIS. 

This is described by Mayer as following distemper in dogs. It 
seems to begin in the epithelial layer of the conjunctiva, which 
becomes dry, lustreless, spotted, opaque and fatty so that water 
runs over it without wetting it. It may extend deeply into the 
substance of the cornea and lead to the development of a scar. 
When scraped and examined under the microscope the scrapings 
are found to consist of epithelium undergoing fatty degeneration 
and myriads of xerosis bacilli. As the disease takes occasion to 
attack by reason of the debility of the system, the treatment is 
mainly corroborative and tonic, including the arrest of the affec- 
tion on which the weakness depends. The early application of 
antiseptics is desirable (iodoform i, vaseline lo; mercuric 
chloride i, vaseline 3000). Warm compresses and a bandage 
may be tried. 
378 



WOUNDS OF THE CORNEA. 

hamcM, whip, nail, hay, slimw, stubble, thistles, spikes, twigs, 
pine needles, ocmes, bardocks, stones, gravel , glass, splinten of wood or 
metal, scratches, stings. Symptoms : dosed lids, epiphora, sight of lesion, 
soon clondy swelling, opacity. Treatment : antiseptic bandage and lotion, 
boric add, sublimate, potassium permanganate, avoid lead or dnc ; atropia, 
cocaine, with perforation, l>andage, eserine, excision. For foreign body, 
antiseptic cotton, spud or curette. 

Causes, Corneal wounds are common in working animals by 
reason of contact with harness, canes, whips, etc., and in the 
stable from contact with nails or with the hard ends of hay or 
straw. At pasture the cornea is injured by the ends of long 
stubble, the sharp points of thistles, the spikes of various thorny 
plants, and twigs of bushes and trees. The last named factors 
are especially operative in hunters and horses worked in forests. 
Punctures with pine needles and cones, and with burdocks, are 
other common causes. Stones, gravel, pieces of glass, and 
splinters of wood or metal, produce traumas of the cornea, and, 
in cats and dogs, scratches and even perforations with the claws 
are common. In this connection the stings of insects are not to 
be forgotten. 

Symptoms, There is always a prompt and complete closure of 
the eyelids and a profuse secretion of tears. Then on parting 
the eyelids with finger and thumb, the lesion of the cornea, its 
nature and extent should be recognizable. In case of a small, 
punctured wound, however, as with a smooth thorn or other 
conical body, the normal elasticity of the corneal tissue may lead 
to such a perfect coaptation of the divided edges that the lesion 
may escape even a close scrutiny. If the case is seen early, be- 
fore time has been allowed for cloudy swelling and opacity the 
wound is all the more likely to escape observation. In incised, 
scratched and torn wounds, on the other hand, the seat and nature 
of the lesion are made out with the greatest ease. 

Treatment of a slight wound which is at once recent and free 

from infection, is by a simple antiseptic bandage and lotion. 

Boric acid (i : loo), isublimate solution (i : 5000) or potassium 

permanganate solution (i : ibo) may be used. Lead and even 

379 



380 Veterinary Medicine, 

zinc salts, are liable to precipitate in the abraded tissue and cause 
a lasting opacity. If the pain is severe it may be moderated by 
the addition of atropia sulphate, or a solution of i to 100 water 
may be instilled into the eye several times daily. Cocaine makes 
an excellent substitute. In deeper wounds, perforating the cor- 
nea and allowing the escape of aqueous humor, there may be 
prolapse of the iris through the wound. It may be pressed back 
with a flat sterilized spatula, and retained by bandage and a course 
of eserine. Should it still escape, it must be seized with forceps, 
drawn out and snipped off with a sharp pair of sterilized scissors. 
The greatest care must be taken to avoid infection which may 
cause panophthalmitis and destruction of the entire eyeball. 



FOREIGN BODIES IN THE CORNEA. 

In case of penetration of the cornea by thorns, thistles, glass, 
metal, etc. , there usually follows inflammation with a red area 
around the offending object. If the foreign body is a piece of 
iron there is a brownish area caused by iron oxide. Focal or 
transillumination will usually reveal the object. Should both 
fail, a solution of fluorescin when applied will develop a greenish 
area around it. 

Treatment may be made as advioed by Gould by pressing a 
Httle antiseptic cotton to the front of the eye, so as to entangle 
and withdraw the foreign body when the eyeball is rolled. Fail- 
ing in this we may cocainize the eye and remove the offending 
object with a small curette or spud. A careful focal illumination 
of the eye will enable the operator to see and remove the smallest 
particles without injury. Subsequent treatment is that of wounds. 



ACUTE KERATITIS. INFLAMMATION OF THE 
CORNEA. 

Extension from conjanctivitis, wounds, foreifpi bodies, bites, stings, 
blows, infections, filaria. Symptoms : eye tender, closed, epiphora, red, 
pannns, photophobia, conn^ested sclera, opaque or ramified red cornea, or 
diffuse red, exudation, suppuration, corneal abscess, ulcer, perforation, pro- 
lapsus iris, panophthalmia. Focal illumination. Recovery. Permanent 



Acute Keratitis, Inflammation of the Cornea, 381 

cicatrix or opacity. Lesions : exudates of lymph and leucocytes into cor- 
neal layers : embryonic tissue vascularizitton : abscess : ulcer : cicatrix : 
opacity : staphyloma : hjrpopion : prolapsus iridis : panophthalmia. Treat- 
ment : antiseptic astringents, atropine, leeching, derivatives, blister, seton, 
opacities; in severe cases antiseptic puncture, sublimate lotion, silver 
nitrate, potassium permanganate, boric acid, pyoktanin : in perforations 
antiseptic bandage and eserine, iridectomy : in chronic case ^ mercury oxide. 

Keratitis occurs in all domestic animals as a primary disease, or 
as an extension from conjunctivitis. 

Causes. Extension from acute, enzootic, infections conjuncti- 
vitis in sheep and cattle has been noticed by a great number of 
observers. Bayer and Lohoff have studied maculated keratitis of 
the superficial layers in horses. Again it has followed wounds by 
foreign bodies, spikes of vegetables, particles of iron and glass, 
blows of whips, or insects, stings, etc. It also occurs in con- 
nection with the local action of particular poisons, such as variola 
(foot and mouth disease), canine distemper, etc., and from the 
local irritations caused by trichiasis or entropion or by the filariae 
lachrymalis (ox) and palpebralis (horse). 

Symptoms, The eye is extremely sensitive, and habitually 
closed, with a profuse flow of tears, and a disposition to resist 
opening of the lids. When exposed the cornea is seen to be 
more or less clouded and perhaps rejddened by the formation 
of vessels proceeding from its sclerotic margin. This is known 
zs pannus. If the anterior chamber is still visible the pupil is 
found to be contracted showing photophobia. The congestion 
is first visible in the sclerotic and in the absence of pigment 
is most intense near the margin of the cornea. Upon the cor- 
nea itself it is preceded by a deep white opacity, into which 
the vascularity gradually extends. The whole cornea may finally 
become of a bright pink hue. 

The congestion of the cornea may advance to fibrinous exuda- 
tion, or the formation of pus between its layers, to molecular 
degeneration and the formation of ulcer, or even to perforation 
and escape of the aqueous humor. In this case prolapsus iris, 
panophthalmia and destruction of the eye are likely to ensue. 

Ulcer if not readily seen with unaided vision can be easily 
recognized by the aid of focal illumination, and abscess can be 
detected by the presence of a sharply circumscribed centre of in- 



382 Veterinary Medicine, 

tense opacity, white or yellow, and some bulging of the mem- 
brane. 

The pus may be absorbed, or it may escape by rupture and 
discharge externally, or into the anterior chamber when the re- 
sistance is least in that direction, and when this takes place, a 
dangerous internal infective inflammation is the result. 

In the slighter forms of keratitis the inflammation may come 
early to a standstill, and recede, tenderness and photophobia pass 
off, the eyelids may be opened, and the corneal opacities gradually 
disappear. If any portion of the cornea has become vascular, that 
portion is liable to remain opaque or even pink. 

Lesions, Under the influence of an irritant on the cornea, the 
vessels in the margin of the sclerotic become actively congested 
and pour out lymph freely, leucocytes also escape and with the 
lymph pass through the lymph channels into the substance of the 
corneal tissue. Here they undergo active fission and increase, 
and the normal cells of the corneal tissue multiply in like manner, 
so that in a short time there is an extraordinary production of 
embryonic cells. Into the embryonic tissue so formed, blood 
escapes from forming loops of new vessels, and this goes on ex- 
tending until the whole cornea may have become vascular. 
Degenerations in the newly formed structure may result in sup- 
puration, {hypopyonkeratitis) or molecular decay and ulceration, 
{ulcus cornea) or organization may take place into the fibrous 
tissue with contraction and permanent opacity, {macula) or a 
hyperplasia may form in the shape of a staphyloma. 

Among the other complications may be named pus in the 
anterior chamber (hypopion), prolapsus of the iris, iritis and 
pahophthalmia. 

Treatment, In the milder form of keratitis, antiseptic astrin- 
gents with atropia sulphate are often effectual : zinc sulphate, 
boric acid or alum (i : 100). Any direct mechanical cause of 
the irritation must be removed, and the eye rendered as far as 
possible antiseptic or aseptic. Derivatives also may be of ser- 
vice, and Trasbot especially ad\ases bleeding from the angular 
vein of the eye but only in the very earliest stages. Cupping, 
leeching or setons may be employed. Excessive tension may 
be relieved by puncture of the cornea near its margin. The 
remaining opacity after the inflammation has subsided may 



Poisoning with Cotton Seed or Cotton Seed Meal. 383 

tisually be removed by touching it daily with a camel's hair 
brush dipped in a solution of silver nitrate (i : 200). 

In the more severe cases antiseptic lotions are even more es- 
sential, mercuric chloride (1:5000), potassium permanganate 
(i : 100), boric acid (i : 100), silver nitrate (i :2oo). Careful 
massage is of value. 

Ulcers may be touched daily with a solution of silver nitrate 
(i :40o), or of pyoktannin (i : 100). 

Perforations must be treated by antiseptic bandage, eserin, 
and in case of necessity, iridectomy as advised under perforating 
wounds. 

Abscesses of the cornea should be opened with a flamed needle 
and treated with antiseptic lotions. 

Obstinate cases are often benefitted by ointment of yellow oxide 
of mercury i, vaseline 10, or by the red oxide of mercury or 
calomel. 



POISONING WITH COTTON SEED OR COTTON SEED 

MEAL. 

Poisons in cotton plant : on man, pig, cow, stock cattle. Symptoms in 
latter: Nervousness, debility, exhaustion, in- coordination, paresis, dysp- 
noea, dullness, anorexia, drooping head, trembling, lachrymation, corneal 
ulcer, opacity, vesiculation ; unilateral or bilateral ; with rest and change 
of food recover in five days except eye lesions. Treatment ; suspend cot- 
ton seed, purge, and treat eye lesions. 

The cotton plant develops poisons for various genera of ani- 
mals. The bark of the root is a favorite abortifacient for woman 
and may be used for the same purpose in the domestic animals. 
The seed when fed continuously to swine will destroy life with 
symptoms of scorbutus, and grave constitutional disorders. Cot- 
ton seed meal fed in excess to dairy cows has a bad reputation 
for inducing garget and mammitis. In stock cattle it has the 
reputation of producing diarrhoea, running from the eyes, ab- 
scess and ulceration of the cornea, staphyloma, hyperthermia 
(103° to 109° F.), swelled legs, congestion of the liver and 
spleen, and high colored urine. As described by Dr. F. C. 
McCurdy, of Kansas City, the southern cattle arrive in poor con- 
dition, seem nervous, weak and exhausted, move with an uncer- 



384 Veterinary Medicine. 

tain, staggering gait, and may fall and make convulsive but in- 
effectual efforts to rise. Dyspnoea, blue mucosae, and protruded 
tongue are noticeable in such cases. In the slighter cases, dull- 
ness, inappetence, suspended rumination, drooping head, and 
trembling limbs are characteristic features, and profuse lachry- 
mation is constant. In some eyes there is a small opaque spot 
around a minute ulcer containing small granules like dust or 
sand, and situated in the centre of the cornea on the line of ap- 
proximation of the two eyelids. Larger opaque areas when 
present were generally confined to the corneal surface, without 
any areola of distended vessels, and without a vascular zone at 
the junction of cornea and sclera. In certain cases the whole 
transparent cornea stood out in the form of a vesicle, so promi- 
nently as to interfere with closure of the eyelids. The affection 
might attack both eyes or only one. 

An important feature is that cattle coming from the cars in 
this condition and left at rest for five days on hay without cotton 
seed recovered rumination and appetite, and the weakness and 
nervous excitement or depression disappeared. There remained 
only the lesions of the eye which progress tardily according to 
their extent or severity. 

The southern origin of the cattle, together with the congested 
liver and spleen and the high colored urine would have suggested 
the southern cattle fever, but from the promptitude of the re- 
covery under a change of regimen and the prominence of the 
lesions of the eye. 

The important point in connection with this subject is the 
prophylaxis by avoidance of the too liberal diet of cotton seed. 
When the disease has actually set in, the true course is to suspend 
this aliment, clear the bowels of any that may remain therein, 
and treat the lesions of the eyes according to their respective con- 
ditions. 



CHRONIC KERATITIS. 

Sequel of trichiasis, entropion, eczema, etc Age. Sjrmptoms : moder- 
ate, lids partly closed, cilia matted together, crusted, cornea clouded, dnlU 
with ramifying vessels. Resolution. Fibroid degeneration, permanent 
opacity. Treatment : tonic regimen, out-door exercise, iron, bitters, calcium 
sulphide, astringent antiseptic collyria, atropia, mercury oxide. 



Chronic Keratitis, 385 

This is especially common in dogs in warm latitudes. Trichiasis 
and entropion are perhaps the most common of the direct causes. 
Eczema and other skin eruptions affecting the lids are additional 
causes, while old and debilitated dogs are especially subject to the 
affection. It is less frequent in horses. 

The symptoms are much less severe than in the acute form. 
The lids are usually partially but rarely completely closed, 
lachrymation may be absent and is never excessive, the secre- 
tion usually sticks together the cilia and lids, and always forms 
crusts on them, the palpebrae are less sensitive than in acute 
keratitis, the cornea is habitually clouded of a bluish-white color, 
yet in the main partially transparent and without the disc 
opacities of the acute type of disease, and the pupil, which is 
usually visible in a good light or under oblique illumination, may 
be slightly but is not excessively contracted. The surface of the 
cornea seems to have lost some of its polish, and in its sub- 
stance blood vessels can usually be made out. 

Under favorable conditions these cases may end in resolution 
and especially under a change of food and environment. In 
less fortunate cases they result in a fibroid degeneration of the 
cornea and deep permanent opacity. 

Treatment. It is usually desirable to change the regimen so 
as to improve the general health, and to allow a fair amount 
of out-door exercise. In the very old and debilitated the case 
is rather hopeless. A course of iron or bitters will sometimes 
have a good effect. In other cases sulphide of calcium yV grain 
thrice a day will prove useful. Eczema must be treated se- 
cundum artem. 

Locally astringent and antiseptic coUyria may be used as in 
the acute form. Atropia, 5 grs. to the oz., is a valuable ad- 
juvant, to be instilled in drops. Ointment of yellow oxide of 
mercury, a piece like a pin head rubbed inside the lids once 
or twice a day often acts well. Finally Trasbot strongly com- 
mends liquor of Van Swieten. 



25 



OPACITY OF THE CORNEA. NEBULA. MACULA. 

LEUCOMA. 

Nebula, macula, lencoma, pigment spots, infiltration, cicatrix, vascular 
or not, result of lead, silver or cocaine. Treatment : silver nitrate solution 
in young and vigorous ; calomel : iodoform : avoid mercury and iodine at 
the same time. Tatooing. 

As a sequel of inflammation of the cornea, persistent opacities 
are very common occurrences. These may last only a short time 
after the subsidence of the inflammation, or they may be per- 
sistent and chronic. They are of all degrees of severity from a 
mere bluish haze to a dense white cloud, or a dark pigment spot. 

The term nebula is given to the slightest form which appears 
as a grayish blue but still transparent blue and may be so slight 
as to pass without recognition except under focal or oblique il- 
lumination. It shades off gradually into the adjacent healthy 
cornea, and is often seen as a marginal zone when the centre of 
the cornea is clear. 

Macula is more marked, requiring no special illumination to 
detect it, especially when the dark pupil forms a background for 
the affected area. It is not, however, of a clear white, but of a 
grayish blue tint. 

Leucoma is a dense white spot or patch which reflects all the 
light falling upon it, and has usually a sharply circumscribed 
margin. 

Pigment spots are usually on the membrane of Descemet and 
are the result of a previous adhesion of the iris and detachment 
of a portion of its pigment. 

The white opacity may be merely a remnant of inflammatory 
infiltration or it may be a. fibrous cicatrix with or without a re- 
maining minute ulcer. It may be the result of an insoluble de- 
posit of lead or silver in the tissues. Sometimes it will form as 
the result of the application of cocaine. 

Treatment, A case of slight inflammatory infiltration can 
usually be cleared up by touching it daily with a solution of 2 
grs. silver nitrate in an ounce of distilled water. This is es- 
pecially satisfactory in the young and healthy, in which the 
386 



Uker of the Cornea, 387 

power of repair is greatest. Finely powdered calomel or iodo- 
form applied to the cornea will often prove effective. In case 
potassium iodide has been given by the mouth, calomel or corro- 
sive sublimate is liable to form mercurous or mercuric iodide 
and cause ophthalmia. The same is true of iodoform if mercury 
has been given internally. As a last resort tatooing the spot has 
been resorted to, to hide the opacity. 



ULCER OF THE CORNEA. 

Infection of abrasions may cause ulcer. Age. House dogs. Puppies on 
vegetable food. Exhaustion. Starvation. Improper, insufficient diet. 
Specific microbes and toxins. Symptoms : Ulcer with peripheral zone of 
opacity. Photophobia. In marasmus little other local trouble. Diagnosis 
by oblique focal illumination or fluorescin. Granulation of Descemet's 
membrane. Escape of aqueous. Keratitis. Panophthalmia. Staphyloma 
Prognosis in debilitated, vigorous. Treatment : tonics, fresh air, good 
food, sunshine, exercise, silver nitrate, mercuric chloride, iodoform, alcohol, 
chlorine water, boric acid, cocaine, eserine, atropine, warm antiseptic com- 
press, juice of fresh cassava. 

Causes, Wounds of the cornea, making an infection entrance 
for pus microbes, are liable to lead to ulceration, and a corres- 
ponding destruction of the epithelium and superficial layers by 
inflammation, may start a similar ulcerative process. Apart from 
these conditions, ulceration is especially liable to occur in very 
old dogs, in closely confined house dogs, in puppies raised on an 
exclusive diet of vegetable food, and in animals worn out by 
disease, exhaustion, starvation, or improper and insufl&cient diet. 
Majendie's dogs fed on sugar, starch and other imperfect diet, 
sufiFered in this way. Finally, the local action of certain specific 
disease poisons, enzootic purulent ophthalmia, canine distemper, 
dogpox (Trasbot), equine influenza (Schindelka), sheep-pox, 
and blennorrhoea (MoUer), leads to ulceration. 

Symptoms. In keratitis there is usually a marked local opacity 
in the centre of which the breach of the surface may be found. 
The attendant photophobia with closure of the lids and pupil is 
strongly suggestive of ulcer. In the specific diseases, the local 
inflammation, the rapid progress of the lesion and the coexist- 



388 Veterinary Medicine, 

ence of the particular infective disease are characteristic. In 
cases due to debility and marasmus the disease may appear with 
little indication of attendant irritation, lachrymation, tenderness, 
photophobia, or even opacity. At one circumscribed point only 
is there a grayish cloud, perhaps no more than a thirtieth of an 
inch in diameter, and slightly projecting. This becomes soft 
and gelatinous and finally drops off, leaving a shallow excavation 
or abrasion, surrounded by a narrow grayish zone. This ne- 
crobiosis may extend inward and even penetrate the membrane, 
before the lesion has enlarged to more than a hemp seed in diam- 
eter. In other cases lateral extension occurs. 

It is always important to recognize the ulcer at an early stage, 
and this may be done by oblique focal illumination and the use 
of a magnifying lens. In case of doubt a drop of solution of 
fluorescin placed on the cornea and at once washed out, will 
promptly reveal the lesion by the high color given to the tissues 
which have been denuded. 

When perforation has taken place the membrane of Descemet 
may bulge out of the orifice and undergo granulation, or it may 
open and allow the escape of the aqueous humor. Active kera- 
titis and even panophthalmia are liable to follow perforation. 
Again, the escape of aqueous humor tends to the approximation 
or contact of the iris or lens, with the cornea, where it may be- 
come adherent and staphyloma may ensue, or a central cataract 
forms. 

Prognosis is unfavorable in debilitated subjects, and when the 
lesion is extensive and in the line of vision. In slight recent 
cases in good constitutions it is favorable. 

Treatment. Debility must be met by tonics and rich diet, 
fresh air, sunshine and exercise. Specific diseases must be met 
according to their nature. 

Locally the daily application of silver nitrate lotion (i : 200) is 
often very effective, proving an excellent antiseptic, checking the 
microbian proliferation, and coagulating the albumen in the 
wound so as to form an antiseptic barrier to further invasion. A 
mercuric chloride solution ( i : 5000) is an excellent substitute. 
Iodoform powder though less antiseptic, is especially valuable in 
favoring the healing process. It is dusted over the cornea, and 
the upper lid immediately drawn down and held over the cornea 
for several minutes. If this is neglected the dry powder is re- 



Corneal Staphyloma. 389 

moved by the flow of tears, and the movement of the lids and 
membrana nictitans. Trasbot recommends dilute alcohol (5 : 100). 
MoUer advises chlorine water reduced to one-third the standard 
strength, or boric acid solution (2 : 100). Bouley found good 
results from a cocaine solution. Cadiot and Almy get the best 
restdts from creolin (.5 to i : 1000) 5 or 6 times a day, with 
eserine. 

In all cases great relief can be obtained from a strong atropia 
lotion (i : 100), in contracting the capillaries and dilating the 
pupil. Indolent cases may often be helped by warm antiseptic 
compresses, which seem to stimulate the circulation and nutri- 
tion of the part. The juice exuding from the scraped fresh cas- 
sava and concentrated to a syrupy consistency, is strongly antisep- 
tic, and used with atropia or pilocarpin is the best agent known 
for senile ulcer (Risley). 

In perforation employ rest, eserine, and antiseptic compression 
bandages and in case of prolapsus iris, excise as already advised. 
ThiS' contracts the pupil, increases tension and favors exit of the 
aqueous humor and the approximation of the edges of the open- 
ing. Eserine has been used for central ulcers; atropine for 
peripheral. 

CORNEAL STAPHYLOMA. 

Bulging corneal scar with adherent iris : from perforation, escape of 
aqneons, intraocular pressure, vascularization of cornea. Diagnosis by cen- 
tral cicatrix, vascularization, pigmentation. Oblique illumination. Treat- 
ment : iridectomy, eserine. Suture. Bnucleation. 

This is a bulging forward of a corneal scar with the iris ad- 
herent to its internal surface. It may originate in perforation of 
the cornea and escape of the aqueous humor, or in intraocular 
pressure that advances the iris until it comes in contact with 
the cornea, which becoming adherent and receiving an abnormally 
large supply of blood or plasma, softens and bulges outward. It 
may grow out to a great length in some cases,' Eck has seen it 
two inches in the horse, and somewhat smaller in an ox. May 
records a case affecting both eyes in the dog. 

Diagnosis is not usually difficult. The scar in the midst of a 
granulating projection of the cornea is nearly conclusive, but the 



390 Veterinary Medicine. 

recognition of pigmentation of the growth and the adherent iris 
often revealed by oblique illumination will nearly always show 
the true nature of the case. 

Treatment is by iridectomy and eserine if the disease can be 
recognized in its eariiest stages, but it is rarely satisfactory. 
Later the choice may be between excision of the staphyloma and 
coaptation of the edges of the wound by suture, and the enuclea- 
tion and removal of the eyeball. The last resort is preferable to 
the continued irritation of the staphyloma by the lids and cilia 
under the ocular movements. 



ECTASIA CORNEA, KERATOCONUS. CONICAL 

CORNEA. 

This consists in a thinning and protrusion of the cornea in the 
form of a blunt cone, without loss of transparency. It has ac- 
cordingly been called staphyloma pellucida. There is a gradual 
attenuation and distension of the corneal tissue from some un- 
known cause. It has been seen mainly in the young and is 
manifestly due to a trophic defect. Stockfleth records a case in 
a fo^l and Bayer in a cow. No satisfactory treatment has been 
proposed, but as the trouble usually comes to a standstill without 
perforation, it can be left to take its course. With rapid in- 
crease and manifest tension antiseptic puncture of the cornea or 
even iridectomy might be tried. 



KERATOGLOBUS. 



This is a variety of ectasia in which the clear, pellucid, pro- 
truding cornea is more globular and less conical in outline. It 
is seen especially with enlargement of the entire eyeball {buph- 
thalmus), 

TUMORS OF THE CORNEA. 

Various tumors may grow from the cornea. Dermoid cysts 
may implicate the cornea and demand excision. Malignant 
growths demand extirpation of the eyeball. 



WOUNDS OF THE SCLERA. 

Covered as it is by the bones of the orbit, and by the palpebrse 
the sclera is little liable to traumatic lesions. Wounds with 
swords, needles, nails, splinters of wood, and other sharp pointed 
bodies are not unknown, however, and penetration by shot is es- 
pecially common in setters. Rupture from blows of clubs, beams, 
poles, stumps, etc., are also met with. 

The symptoms are great fear and apprehension if the head is 
touched, profuse lachrymation with more or less of blood, and 
when the eyelids are separated the wound may be discovered 
and its gravity estimated by protrusion of the vitreous. Slight 
injuries which are not infected heal readily under the treat- 
ment recommended for keratitis. Infecting and penetrating 
wounds are liable to cause panophthalmitis and destruction of 
the eye. Foreign bodies, if present, should be removed when 
possible. Pyoktanin is especially recommended by Stilling. 



EPISCLERITIS. INFLAMMATION OF THE SCLERA. 

Scleritis in man is described as a manifestation of rheumatism, 
gout, or tuberculosis. It occurs in animals in connection with 
traumatic lesions, with iritis, cyclitis and choroiditis and is mani- 
fested by more or less congestion, swelling and tenderness of the 
sclerotic, but is always subordinate in importance and the treat- 
ment demanded is for the more serious disease. 



ECTASIA (BULGING) OF THE SCLERA. 

Cases of this kind are adduced by Scleich and Mayer, in dogs, 
in which there was a corresponding bulging or even an absence 
{colohomd) of the choroid and retina. With a large protrusion of 
the sclera behind, there was a shrinkage of the front of the globe 
(microphthalmus), so that an atrophy might be suspected. The 
condition is irremediable. 
391 



390 Veterinary Medicine, 

recognition of pigmentation of the growth and the adherent iris 
often revealed by oblique illumination will nearly always show 
the true nature of the case. 

Treatment is by iridectomy and eserine if the disease can be 
recognized in its earliest stages, but it is rarely satisfactory. 
Later the choice may be between excision of the staphyloma and 
coaptation of the edges of the wound by suture, and the enuclea- 
tion and removal of the eyeball. The last resort is preferable to 
the continued irritation of the staphyloma by the lids and cilia 
under the ocular movements. 



ECTASIA CORNEA. KERATOCONUS. CONICAL 

CORNEA. 

This consists in a thinning and protrusion of the cornea in the 
form of a blunt cone, without loss of transparency. It has ac- 
cordingly been called staphyloma pellucida. There is a gradual 
attenuation and distension of the corneal tissue from some un- 
known cause. It has been seen mainly in the young and is 
manifestly due to a trophic defect. Stockfleth records a case in 
a fo^l and Bayer in a cow. No satisfactory treatment has been 
proposed, but as the trouble usually comes to a standstill without 
perforation, it can be left to take its course. With rapid in- 
crease and manifest tension antiseptic puncture of the cornea or 
even iridectomy might be tried. 



KERATOGLOBUS. 



This is a variety of ectasia in which the clear, pellucid, pro- 
truding cornea is more globular and less conical in outline. It 
is seen especially with enlargement of the entire eyeball {buph- 
thcUmus), 

TUMORS OF THE CORNEA. 

Various tumors may grow from the cornea. Dermoid cysts 
may implicate the cornea and demand excision. Malignant 
growths demand extirpation of the eyeball. 



WOUNDS OF THE SCLERA, 

Covered as it is by the bones of the orbit, and by the palpebrse 
the sclera is little liable to traumatic lesions. Wounds with 
swords, needles, nails, splinters of wood, and other sharp pointed 
bodies are not unknown, however, and penetration by shot is es- 
pecially common in setters. Rupture from blows of clubs, beams, 
poles, stumps, etc. , are also met with. 

The symptoms are great fear and apprehension if the head is 
touched, profuse lachrymation with more or less of blood, and 
when the eyelids are separated the wound may be discovered 
and its gravity estimated by protrusion of the vitreous. Slight 
injuries which are not infected heal readily under the treat- 
ment recommended for keratitis. Infecting and penetrating 
wounds are liable to cause panophthalmitis and destruction of 
the eye. Foreign bodies, if present, should be removed when 
possible. Pyoktanin is especially recommended by Stilling. 



EPISCLERITIS. INFLAMMATION OF THE SCLERA. 

Scleritis in man is described as a manifestation of rheumatism, 
gout, or tuberculosis. It occurs in animals in connection with 
traumatic lesions, with iritis, cyclitis and choroiditis and is mani- 
fested by more or less congestion, swelling and tenderness of the 
sclerotic, but is always subordinate in importance and the treat- 
ment demanded is for the more serious disease. 



ECTASIA (BULGING) OF THE SCLERA. 

Cases of this kind are adduced by Scleich and Mayer, in dogs, 
in which there was a corresponding bulging or even an absence 
{coloboma) of the choroid and retina. With a large protrusion of 
the sclera behind, there was a shrinkage of the front of the globe 
(microphthalmus), so that an atrophy might be suspected. The 
condition is irremediable. 
391 



390 Veterinary Medicine, 

recognition of pigmentation of the growth and the adherent iris 
often revealed by oblique illumination will nearly always show 
the true nature of the case. 

Treatment is by iridectomy and eserine if the disease can be 
recognized in its earliest stages, but it is rarely satisfactory. 
Later the choice may be between excision of the staphyloma and 
coaptation of the edges of the wound by suture, and the enuclea- 
tion and removal of the eyeball. The last resort is preferable to 
the continued irritation of the staphyloma by the lids and cilia 
under the ocular movements. 



ECTASIA CORNEA. KERATOCONUS. CONICAL 

CORNEA. 

This consists in a thinning and protrusion of the cornea in the 
form of a blunt cone, without loss of transparency. It has ac- 
cordingly been called staphyloma pellucida. There is a gradual 
attenuation and distension of the corneal tissue from some un- 
known cause. It has been seen mainly in the young and is 
manifestly due to a trophic defect. Stockfleth records a case in 
a fo^l and Bayer in a cow. No satisfactory treatment has been 
proposed, but as the trouble usually comes to a standstill without 
perforation, it can be left to take its course. With rapid in- 
crease and manifest tension antiseptic puncture of the cornea or 
even iridectomy might be tried. 



KERATOGLOBUS. 



This is a variety of ectasia in which the clear, pellucid, pro- 
truding cornea is more globular and less conical in outline. It 
is seen especially with enlargement of the entire eyeball {^buph- 
thalmus). 

TUMORS OF THE CORNEA. 

Various tumors may grow from the cornea. Dermoid cysts 
may implicate the cornea and demand excision. Malignant 
growths demand extirpation of the eyeball. 



WOUNDS OF THE SCLERA. 

Covered as it is by the bones of the orbit, and by the palpebrse 
the sclera is little liable to traumatic lesions. Wounds with 
swords, needles, nails, splinters of wood, and other sharp pointed 
bodies are not unknown, however, and penetration by shot is es- 
pecially common in setters. Rupture from blows of clubs, beams, 
poles, stumps, etc., are also met with. 

The symptoms are great fear and apprehension if the head is 
touched, profuse lachrymation with more or less of blood, and 
when the eyelids are separated the wound may be discovered 
and its gravity estimated by protrusion of the vitreous. Slight 
injuries which are not infected heal readily under the treat- 
ment recommended for keratitis. Infecting and penetrating 
wounds are liable to cause panophthalmitis and destruction of 
the eye. Foreign bodies, if present, should be removed when 
possible. Pyoktanin is especially recommended by Stilling. 



EPISCLERITIS. INFLAMMATION OF THE SCLERA. 

Scleritis in man is described as a manifestation of rhetmiatism, 
gout, or tuberculosis. It occurs in animals in connection with 
traumatic lesions, with iritis, cyclitis and choroiditis and is mani- 
fested by more or less congestion, swelling and tenderness of the 
sclerotic, but is always subordinate in importance and the treat- 
ment demanded is for the more serious disease. 



ECTASIA (BULGING) OF THE SCLERA. 

Cases of this kind are adduced by Scleich and Mayer, in dogs, 
in which there was a corresponding bulging or even an absence 
{coloboma) of the choroid and retina. With a large protrusion of 
the sclera behind, there was a shrinkage of the front of the globe 
(microphthalmus), so that an atrophy might be suspected. The 
condition is irremediable. 
391 



390 Veterinary Medicine. 

recognition of pigmentation of the growth and the adherent iris 
often revealed by oblique illumination will nearly always show 
the true nature of the case. 

Treatment is by iridectomy and eserine if the disease can be 
recognized in its earliest stages, but it is rarely satisfactory. 
Later the choice may be between excision of the staphyloma and 
coaptation of the edges of the wound by suture, and the enuclea- 
tion and removal of the eyeball. The last resort is preferable to 
the continued irritation of the staphyloma by the lids and cilia 
under the ocular movements. 



ECTASIA CORNEA. KERATOCONUS. CONICAL 

CORNEA. 

This consists in a thinning and protrusion of the cornea in the 
form of a blunt cone, without loss of transparency. It has ac- 
cordingly been called staphyloma pellucida. There is a gradual 
attenuation and distension of the corneal tissue from some un- 
known cause. It has been seen mainly in the young and is 
manifestly due to a trophic defect. Stockfleth records a case in 
a fo^l and Bayer in a cow. No satisfactory treatment has been 
proposed, but as the trouble usually comes to a standstill without 
perforation, it can be left to take its course. With rapid in- 
crease and manifest tension antiseptic puncture of the cornea or 
even iridectomy might be tried. 



KERATOGLOBUS. 



This is a variety of ectasia in which the clear, pellucid, pro- 
truding cornea is more globular and less conical in outline. It 
is seen especially with enlargement of the entire eyeball {buph- 
thalmus^. 

TUMORS OF THE CORNEA. 

Various tumors may grow from the cornea. Dermoid cysts 
may implicate the cornea and demand excision. Malignant 
growths demand extirpation of the eyeball. 



WOUNDS OF THE SCLERA. 

Covered as it is by the bones of the orbit, and by the palpebrae 
the sclera is little liable to traumatic lesions. Wounds with 
swords, needles, nails, splinters of wood, and other sharp pointed 
bodies are not unknown, however, and penetration by shot is es- 
pecially common in setters. Rupture from blows of clubs, beams, 
poles, stumps, etc., are also met with. 

The symptoms are great fear and apprehension if the head is 
touched, profuse lachrymation with more or less of blood, and 
when the eyelids are separated the wound may be discovered 
and its gravity estimated by protrusion of the vitreous. Slight 
injuries which are not infected heal readily under the treat- 
ment recommended for keratitis. Infecting and penetrating 
wounds are liable to cause panophthalmitis and destruction of 
the eye. Foreign bodies, if present, should be removed when 
possible. Pyoktanin is especially recommended by Stilling. 



EPISCLERITIS. INFLAMMATION OF THE SCLERA. 

Scleritis in man is described as a manifestation of rheumatism, 
gout, or tuberculosis. It occurs in animals in connection with 
traumatic lesions, with iritis, cyclitis and choroiditis and is mani- 
fested by more or less congestion, swelling and tenderness of the 
sclerotic, but is always subordinate in importance and the treat- 
ment demanded is for the more serious disease. 



ECTASIA (BULGING) OF THE SCLERA. 

Cases of this kind are adduced by Scleich and Mayer, in dogs, 
in which there was a corresponding bulging or even an absence 
{colobomd) of the choroid and retina. With a large protrusion of 
the sclera behind, there was a shrinkage of the front of the globe 
(jnicrophthalmus), so that an atrophy might be suspected. The 
condition is irremediable. 
391 



390 Veterinary Medicine, 

recognition of pigmentation of the growth and the adherent iris 
often revealed by oblique illumination will nearly always show 
the true nature of the case. 

Treatment is by iridectomy and eserine if the disease can be 
recognized in its earliest stages, but it is rarely satisfactory. 
Later the choice may be between excision of the staphyloma and 
coaptation of the edges of the wound by suture, and the enuclea- 
tion and removal of the eyeball. The last resort is preferable to 
the continued irritation of the staphyloma by the lids and cilia 
under the ocular movements. 



ECTASIA CORNEA. KERATOCONUS. CONICAL 

CORNEA. 

This consists in a thinning and protrusion of the cornea in the 
form of a blunt cone, without loss of transparency. It has ac- 
cordingly been called staphyloma pellucida. There is a gradual 
attenuation and distension of the corneal tissue from some un- 
known cause. It has been seen mainly in the young and is 
manifestly due to a trophic defect. Stockfleth records a case in 
a fo^l and Bayer in a cow. No satisfactory treatment has been 
proposed, but as the trouble usually comes to a standstill without 
perforation, it can be left to take its course. With rapid in- 
crease and manifest tension antiseptic puncture of the cornea or 
even iridectomy might be tried. 



KERATOGLOBUS. 



This is a variety of ectasia in which the clear, pellucid, pro- 
truding cornea is more globular and less conical in outline. It 
is seen especially with enlargement of the entire eyeball {buph- 
tkalmus). 

TUMORS OF THE CORNEA. 

Various tumors may grow from the cornea. Dermoid cysts 
may implicate the cornea and demand excision. Malignant 
growths demand extirpation of the eyeball. 



WOUNDS OF THE SCLERA. 

Covered as it is by the bones of the orbit, and by the palpebrae 
the sclera is little liable to traumatic lesions. Wounds with 
swords, needles, nails, splinters of wood, and other sharp pointed 
bodies are not unknown, however, and penetration by shot is es- 
pecially common in setters. Rupture from blows of clubs, beams, 
poles, stumps, etc., are also met with. 

The symptoms are great fear and apprehension if the head is 
touched, profuse lachrymation with more or less of blood, and 
when the eyelids are separated the wound may be discovered 
and its gravity estimated by protrusion of the vitreous. Slight 
injuries which are not infected heal readily under the treat- 
ment recommended for keratitis. Infecting and penetrating 
wounds are liable to cause panophthalmitis and destruction of 
the eye. Foreign bodies, if present, should be removed when 
possible. Pyoktanin is especially recommended by Stilling. 



EPISCLERITIS. INFLAMMATION OF THE SCLERA. 

Scleritis in man is described as a manifestation of rheumatism, 
gout, or tuberculosis. It occurs in animals in connection with 
traumatic lesions, with iritis, cyclitis and choroiditis and is mani- 
fested by more or less congestion, swelling and tenderness of the 
sclerotic, but is always subordinate in importance and the treat- 
ment demanded is for the more serious disease. 



ECTASIA (BULGING) OF THE SCLERA. 

Cases of this kind are adduced by Scleich and Mayer, in dogs, 
in which there was a corresponding bulging or even an absence 
{coloboma) of the choroid and retina. With a large protrusion of 
the sclera behind, there was a shrinkage of the front of the globe 
(jmicrophthalmus), so that an atrophy might be suspected. The 
condition is irremediable. 
391 



PROLAPSE OF THE IRIS. 

This has been already referred to as a complication of perfor- 
ating ulcer or wound of the cornea. If it cannot be returned and 
maintained by a compression bandage and eserine, the only resort 
is to draw out the prolapsing portion and cut it off with scissors, 
the eye and instruments having been rendered thoroughly aseptic. 



INTERNAL OPHTHALMIA. 

Diagnosis of internal ophthalmias difficult. Causes : as in conjunctivitis, 
extension of conjunctivitis or keratitis to iris, choroid, ciliary circle, retina ; 
Lymphatic constitution, damp soil, air and stable, pit life, dentition, grain 
feeding, training. Symptoms : ophthalmic symptoms generally, enlarged 
ciliary vessels in sclera not movable ; white zone around corneal margin ; 
iris dull, brownish, sluggish ; intraocular tension increased : flocculi in 
aqueous humor : photophobia : oblique focal illumination ; sudden change 
from darkness to light : synechia : ophthalmoscope. Cyclitis. Diagnosis : 
from keratitis, recurrent ophthalmia. Lesions : according to chief seat of 
the disease: inflammation of Descemet's membrane, iris, choroid, ciliary 
circle, lens, vitreous and retina in variable degree. Opacity of aqueous, 
lens, capsules, or vitreous. Prognosis : always grave, often vision impaired 
or lost. Treatment : rest, pure air apart from strong sunshine, removal of 
causes, local bleeding or cupping, derivation, purgative, cooling diuretics: 
locally astringent antiseptic lotions, cocaine, homatropine, blister, undue 
tension antiseptic puncture, mercury oxide ointment ; in rheumatic cases 
salicin or sodium salicylate. 

In the domestic animals it is not always possible to distinguish 
between inflammations affecting different portions of the inner 
and middle coats of the eye (iritis, cyclitis, choroiditis, retinitis), 
so that it is convenient to give in general terms the phenomena 
and treatment of the class known as ophthalmia intemus. This 
is all the more appropriate that inflammation of one of these 
divisions so frequently extends to the others producing /a^^^/A- 
ihalmitis, that the disease in one usually implies an early impli- 
cation of all. 
392 



Internal Ophthalmia, 393 

Causes, Many of the causes of conjunctivitis, when acting 
with special intensity, or for too long a time, may cause internal 
ophthalmia. Severe blows, bruises, punctures, lacerations, sand, 
cinders, dust, lime, foreign bodies inducing traumas, sudden 
transitions from darkness to bright sunshine, habitual exposure 
to sunshine or to the reflection from snow, ice or water, through 
a window in front of the stall, the abuse of the overdraw check 
rein, the glare of electric light or of lightning flashes, draughts 
of cold damp air between windows or doors, the beating of cold 
storms on the eyes and skin, a sudden chill from plunging in 
water or standing in a cold draught when perspiring, blows with 
branches, pine cones or needles in the eye, the constant irritation 
from entropion, trichiasis, burdocks or thistles in the forelock, 
irritant gases, etc., are among the factors which cooperate in 
setting up the disease. Again diseases of the digestive organs, 
rheumatism, influenza, canine distemper, brustseuche, petechial 
fever, variola, eczema, and aphthous fever may be direct causes. 
Conjunctivitis and keratitis are liable to merge into irido-choroidi- 
tis by extension, and above all when owing to perforation 
of the cornea a direct channel is opened for the easy entrance of 
infective, pathogenic microbes. A l3anphatic constitution, con- 
nected with low breeding, or living in a low, damp, cloudy region, 
or in dark, damp, impure stables, has a strongly predisposing in- 
fluence. The period of dentition, connected as it usually is with 
domestication, stabling, grain feeding, and training is often a 
potent accessory cause. 

Symptoms, With the general phenomena of superficial or ex- 
ternal ophthalmia there are some indications which may be called 
pathognomonic. These may be summarized as follows : in eyes 
devoid of pigment the enlarged ciliary vessels run deeply and are 
not tortuous, nor mobile when rubbed ; the scleral redness increases 
toward the margin of the cornea, but leaves a white zone in front 
of the penetration of the ciliary vessels ; the iris has lost its clear re- 
flection, appearing dull or brownish ; the pupil is contracted and 
sluggish in response to light and darkness, it may be fixed or may 
show marked unevenness in its margin : the tension of the eye ball 
is often increased, flocculi of lymph may be seen in the aqueous humor 
settling into the lower part of the anterior chamber. This deposit 
may be white or yellowish or it may even be reddened by ex- 



394 Veterinary Medicine, 

travasated blood especially in traumatic injuries. In traumas, too, 
the cornea and even the aqueous or vitreous humor may be 
opaque. In cases resulting from exposure to cold or from inter- 
nal causes, the media of the eye are at first clear and transparent. 
The condition of the interior of the eye is usually to be learned 
by examining the patient as he stands facing the light from a 
dark back ground. A stable door or window will afford the re- 
quisite amount of rays falling from above and from each side 
upon the interior of the eye. The observer looks indirectly or 
obliquely and under favorable conditions can see the iris and 
through the pupil. If the pupil is unduly closed it may often be 
dilated by instilling a few drops of a 5 per cent, solution of 
atropia and waiting for»fifteen or twenty minutes. 

The examination is made more satisfactorily with a candle or 
other single source of light in a dark chamber. If this light is 
surrounded by a chimney opaque except at one side which is 
directed toward the eye, the results are much more satisfactory. 
Focal illumination with a biconvex lens, or oblique illumination 
will show a swollen condition of the iris with uneven bulging 
swellings at different points, and generally a lack of the clear 
dark surface which marks the healthy iris. It may be yellowish 
or brownish, rather than dark, or blue, or yellow, but is always 
duller than normal. The pupil may be contracted or dilated, but 
is always uneven at the margin according to the degree of con- 
gestion of the different portions. It may be quite immovable 
under the stimulus of light and darkness, and is always sluggish 
as compared with the healthy condition. To test this reflex 
action, the one eye may be bandaged, and the other eye covered 
with the palm of the hand for one or two minutes. When ex- 
posed the pupil will be found to be widely dilated, and in the 
healthy eye it will rapidly contract and dilate alternately until it 
has reached a condition of adaptation to the intensity of the light 
when it will remain immovable. With the inflamed iris these 
contractions and dilatations will be lacking altogether, or they 
will be sluggish and imperfect in various degrees according to 
the intensity of the inflammation, the degree of congestion or 
the tension of the liquid media of the eye. Restricted move- 
ment may also be due to adhesion to the cornea, (^synechia an- 
terior) or to the capsule of the lens (^synechia posterior). 



Internal Ophthalmia, 395 

When viewed with the ophthalmoscope properly focused the 
choroid may show a lack of its normal lustre and an uneven- 
ness due to the formation of small rounded elevations in con- 
nection with congestion, or exudation, and patches of yellowish 
red or whitish discoloration together with lines of the same color 
following the course of the blood-vessels. It may also reveal 
dark spots of opacity in the lens {cataract) or clouds in the an- 
terior region of the vitreous, the result of exudations. The 
blood-vessels may appear enlarged and tortuous. 

In some cases the exudate may form a false membrane which 
completely closes the pupil. 

A special tenderness around the margin of the cornea is sug- 
gestive of cyclitis. Internal ophthalmia is usually accompanied 
by a variable amount of fever. 

Diagnosis. From simple keratitis, it is distinguished by the 
thickening, discoloration and sluggishness of the iris, by the ab- 
sence, in many cases, of corneal opacity, and of free lachryma- 
tion, and in some instances by increased tension of the eyeball. 

Recurring ophthalmia, which is usually also an internal in- 
flammation, appears more abruptly and often at first with greater 
severity, and accompanied by more hyperthermia. There is 
almost always a bluish white opacity around the margin of the 
cornea, the eye is retracted in its sheath so as to appear smaller 
and the upper lid usually shows a marked angle between its inner 
and middle thirds in place of the evenly curved arch of the 
healthy palpebra. It usually appears for the first time in the 
young and in those that have inherited the susceptibility and 
have been kept on damp soils, in cloudy districts, or dark 
buildings. 

Lesions, These are necessarily varied according as the inflam- 
mation is concentrated on particular parts of the interior of the 
eye. The secreting membrane of the aqueous humor is nearly 
always inflamed giving rise to an exudate and a milky opacity 
of the aqueous humor. The iris is the seat of congestion exuda- 
tion, thickening, cell proliferation and investment by false mem- 
branes. The capsule of the lens is early clouded, may be covered 
by exudate and is rendered vascular in some cases. The choroid 
is also the seat of congestion, exudation and discoloration with 
the covering up at points of its pigmentary layer. The vitreous 



396 Veterinary Medicine, 

and lens finally become the seat of exudation and opacity which 
is liable to prove permanent 

Prognosis, The internal ophthalmias are always to be dreaded. 
In other organs exudates may take place and become organized 
as permanent structures without abolishing the function or ren- 
dering the organ physiologically useless, but in the delicate and 
transparent tissues of the eye, any such permanent product almost 
infallibly causes opacity and loss, or serious impairment of vision. 
In the retina the displacement, derangement, or covering up of 
the cones and rods necessarily interferes with or abolishes sight, 
the opacity of the cornea, lens, capsule, or vitreous interrupts 
the rays of light, and the destruction, or coating over of the pig- 
ment of the choroid leads to undue reflection and destroys vision. 
Besides this the destruction or impairment of one part of the eye, 
changes the refraction and blurs the vision, or interferes with 
accommodation and destroys the utility of the organ. Unless 
therefore the disease can be cut short in its early stages and a 
complete resolution effected it is likely to leave the patient very 
much deteriorated in value. Fortunately it is only in the most 
violent cases or in'very susceptible animals that the disease in the 
one eye is transmitted to the other by sympathy and leads to des- 
truction of that eye as well. 

In the treatment of internal ophthalmia, rest in pure air and 
moderate warmth, away from a fierce glare of light is impera- 
tive. The causes should as far as possible be removed. Next, it 
is desirable to establish derivation. Leblanc and Trasbot attach 
great importance to phlebotomy from the jugular on the same 
side. A more direct local action with less loss of blood may be 
obtained from opening the angular vein of the eye or applying a 
leech beneath the lower lid. In most cases a sufficient derivative 
action can be secured by an active purgative which may be fol- 
lowed by daily doses of cooling diuretics. Locally astringent 
lotions (lead acetate or zinc sulphate i dr. to i qt. water ; mer- 
curic chloride, i : 5000 ; boric acid, 2 : 100 ; pyoktannin, i :iooo) 
in combination with cocaine hydrochlorate, homatropin, atropia 
sulphate, duboisia or hyoscyamin (i : 1000) would be appropriate. 
These may be applied over the eye on a soft cloth, and in cases 
of infective inflammation the more antiseptic agents may be in- 
jected under the lids. When the inflammation is very severe the 



Simple Iritis. 397 

atropia or other sedative agent may be made of the strength of 
I : ICO and a drop or two placed inside the lids with a dropper 
every two or three hours. 

A blister of biniodide of mercury may be applied to a space 
the size of a dollar above the anterior end of the zygomatic ridge, 
or in dogs back of the ear on the side of the neck : or a seton 
may be passed through the skin in the same situation. 

When the eyeball is unduly tense, puncture through the mar- 
gin of the cornea with a fine aseptic lancet will relieve the tension 
and in some cases induce a more healthy action. Assiduous anti- 
sepsis is needful until the wound has healed. 

In other cases benefit can be obtained from the use of an oint- 
ment of yellow oxide of mercury i part, in vaseline 10 parts, or 
of iodoform of the same strength. A small portion the size of a 
grain of wheat is put under the lid, and the latter manipulated 
with the finger to bring it in contact with all parts of the surface. 
In case of a rheumatic origin, salicin and salicylate of soda are 
demanded. 



SIMPLE IRITIS. 



Causes. Symptoms : redness of sclera, in dogs, cats, birds, pigs, with a 
narrow zone of white next the cornea, red scleral vessels immovable, iris 
dull gray or brown, uneven, sluggish in response to light, synechia anterior 
or posterior, lens and capsule clouded or clear, pupillary margin uneven, 
myosis or midriasis, black cataract. Treatment : rest, dark stall or covering, 
head elevated, midriatica, cocaine, antiseptic puncture, purgation, leeches, 
seton, cooling astringent lotions, diuretics, for tension in convalescence 
iridectomy. In traumatic cases careful antisepsis. 

This may come from any one or more of the causes of internal 
ophthalmia above named. The inflammation, however, concen- 
trates itself on the iris so as to overshadow the disease in the ad- 
jacent organs. 

The more distinctive symptoms are the redness of the sclerotic 
in unpigmented organs (swine, birds, dogs, cats), the redness in- 
creasing as it approaches the margin of the cornea but leaving a 
narrow white zone surrounding the edge. The red vessels on 
the sclerotic are not moved with the conjunctiva when the lid is 
moved over the. front of the eye. The front of the iris is dull, 



398 Veterinary Medicine. 

grayish or brownish, it is thickened unevenly and very sluggish 
in response to light and darkness. Not infrequently it is ad- 
herent to the back of the cornea (synechia anterior) or to the 
front of the lenticular capsule (synechia posterior). The lens 
and its capsule may or may not be clouded, but if the interior of 
the vitreous can be seen it is found to be clear. The pupil is 
more or less uneven in outline and sometimes it is torn at its 
inner edge so as to fonn shreds and projecting tongues. Myosis 
(contraction of the pupil) or midriasis (dilatation) may be 
present. If the latter has been preceded by adhesion, a portion 
of the uvea may remain attached to the lenticular capsule consti- 
tuting black cataract. The lens or its capsule may become 
opaque, and a fibrinous membrane may form over the pupil. 

Treatment, Rest for body and eye are essential. A dark stall, 
or a thick covering for the eye is desirable. The head should be 
kept moderately elevated to facilitate the return of blood. The 
pupil should be kept widely dilated to prevent adhesions to the 
lens. Sulphate of atropia 5 grs. to the oz. of water should be 
applied a few drops at a time, thrice a day, or as often as may be 
necessary to secure dilatation. In case the atropia fails to secure 
dilatation a 5 per cent, solution of cocaine should be dropped into 
the eye every three or four minutes for four or five times and 
then another application of atropia may be tried warm. Should 
it still fail and should there be indications of extra congestion 
and swelling of the iris or of excessive tension of the eyeball, relief 
may be obtained by puncturing the cornea. With the reduction 
of the tension the iris will often respond to the midriatic. Bene- 
fit may also be obtained from an active purgative, or the applica- 
tion of leeches in the vicinity of the eye. 

Cooling astringent applications may be kept up over the eye, 
or warm antiseptic applications will often give great relief. 

In obstinate cases the yellow oxide of mercury ointment may 
be applied as advised for internal ophthalmia. 

Cooling diuretics may also be of essential advantage. 

If, after a fair recovery the bulb remains unduly tense, .iridec- 
tomy may be resorted to as a prophylactic measure for the future. 
An incision is made with a lancet close in front of the margin of 
the cornea, and the iris seized and withdrawn with a pair of fine 
forceps, and a portion snipped off with fine scissors. The eye 



Symptomatic or Metastatic Iritis, 399 

and instruments must be rendered absolutely aseptic by carbolic 
acid and boiling water, and the antisepsis of the eye must be 
carefully maintained until the wound is healed. This tends to 
relieve congestion in the iris and to moderate the secretion in the 
anterior chamber, so that the former extreme tension does not 
recur. In making choice of the seat of the iridectomy a selec- 
tion may be made which will do away with adhesions, or one 
that will expose a portion of the lens which is still transparent, 
and which may restore vision when obscured by a cataract. 

In traumatic cases there should be extra care in maintaining a 
thorough antisepsis of the eye as the great danger is that of in- 
fective panophthalmitis. The injection of antiseptic liquids 
under the eyelids, and the covering of the eye with antiseptic 
cotton wool or with a soft rag wet with an antiseptic lotion are 
important factors in treatment. 



SYMPTOMATIC OR METASTATIC IRITIS. 

Complications of infectious diseases, influenza, contagious pneumonia, 
strangles, tuberculosis, omphalitis. Symptoms: exudation offibrine and 
blood, with those of simple iritis. Treatment: as in iritis, plus measures' 
for the specific primary disease. When second eye is threatened enuclea- 
tion. 

Under this head MoUer describes those forms of iritis which 
occur as complications of various infectious diseases. It has 
long been observed that iritis and other ophthalmias, occurred as 
complications of the acute infectious diseases of the respiratory 
organs of the horse formerly known under the general name of 
* * influenza. ' * More recently many veterinarians and others have 
classed these influenza irites separately under the name of * ' pink- 
eye,** The same can be said of ** contagious pneumonia*' 
(brustseuche) of horses which is distinctly caused by the diplococ- 
cus {^streptococcus^ pneumonia equina. Attention was called to 
the iri tic complication of this disease in 1881 by Siedamgrotzky 
and it has been often noticed since. Conjunctivitis is however a 
more frequent complication of this disease than iritis. In both 
influenza and contagious pneumonia the iritis often supervenes 



400 Veterinary Medicine, 

when convalescence has apparently set in. Strangles is another 
affection in which the iris occasionally suffers. Mathieu has 
described tuberculosis of the iris in cattle, and MoUer mentions 
with somehesitancy cases of iritis which complicated the infection 
of the navel in new-bom animals. 

The symptoms of symptomatic iritis vary according to the par- 
ticular infection. In addition to the fibrinous exudate the in- 
fections of the respiratory organs are liable to be complicated by 
blood extravasations. In influenza this may show as deep blotches 
on the bulbar conjunctiva and in chemosis. In contagious 
pneumonia Shiitz met with iritis of a distinctly haemorrhagic 
character. 

In Mathieu' s cases of tubercle of the iris there was first a 
slight lachrymation, and soon the iris assumed a grayish tint, and 
became uneven and unduly approximated to the cornea though it 
failed to become adherent to it. The swellings of the iris in- 
creased and became of a grayish yellow color, and the pupil was 
usually contracted and varied little in size. Post mortem ex- 
amination showed the presence of tubercles. The same con- 
dition has become familiar in connection with experimental inocu- 
lation in the eye. As in ordinary iritis, adhesion to the capsule 
of the lens and cataract are common results. 

Apart from the treatment of the specific primary disease this 
type of iritis demands the same treatment as other forms. Strong 
atropia lotions to prevent or break up adhesions and antiseptic 
astringents are especially indicated. When implication of the 
second eye is threatened it may be desirable to remove the first 
by enucleation. (See Panophthalmitis.) 



FOREIGN BODIES IN THE IRIS. 

These are sometimes fine shot particularly in dogs, and splinters 
of iron and steel in other animals. Their presence can sometimes 
be made out by careful focal illumination. If septic they cause 
violent iritis and panophthalmia. If aseptic they may sometimes 
cause little trouble. If they can be exactly located, they should 
be removed at once before the aqueous humor and cornea become 



Coloboma Iridis. Congenital Aperture in Iris. 401 

clouded. If the ofiFending body is a piece of iron or steel and 
can be reached by a magnet introduced through the original 
wound or through one made with a lancet in the edge of the 
cornea it may be extracted by this means. If it is shot or other 
body that is not attracted by a magnet the portion of the iris in 
which it is entangled may be drawn out with forceps and snipped 
off with fine scissors. Due antiseptic precaution must be exer- 
cised. 



COLOBOMA IRIDIS. CONGENITAL APERTURE IN IRIS. 

This is a congenital defect in which there is an aperture in the 
iris. Hering figures the two eyes of a horse in which these ap- 
peared in the direction of the outer canthus. Renner records a 
case in a foal in connection with intra-bulbar enchondroma. 
Dochtermann and Berlin record that among 64 pigs the result of 
breeding a boar on his daughters and grand-daughters no less 
than 36 showed coloboma. MoUer figures a dog with the same 
affection. 

The condition is not known to prove hurtful to the affected 
animal so that it may be wisely let alone. 



DOUBLE PUPIL. 



Mayer notes a case of congenital double pupil in the horse, a 
bridge extending across the space from the upper to the lower 
border and cutting .off the outer third of the opening. The 
present writer has seen a similar condition as the result of union 
of the corpus nigrum in severe iritis. Section of the bridge is 
possible, though rarely desirable, seeing that it opens a door to 
possible infection. 



ALBINISM. WATCH-EYE. 

The albino is an animal in which there is a complete absence 
of pigment in the eye. It is usually seen in white races of rats, 
26 



402 Veterinary Medicine, 

rabbits and dogs, and both the iris and choroid reflect a pink 
tint. It may cause photophobia and some weakness of vision 
but, in the main, it seems to be harmless to the lower animals. 
In horses it is occasionally seen as a partial defect, a portion only 
of the iris and adjacent sclerotic appearing of a brilliant white 
color. It does not usually seem to impair the vision, so that at 
the worst, it is only looked on as a blemish. It is needless to at- 
tempt a remedy. 



PERSISTENT PUPILLARY MEMBRANE. 

The persistence of this embryonic membrane has been noticed 
in the horse (Schindelka), ox (Meyer), rabbit (Mayerhausen), 
and dog (MoUer). It tends to disappear with the growth of the 
animal and rarely does any perceptible harm. 



OCCLUDED PUPIL. 



This has been frequently found in horses as a sequel of iritis, 
and permanent adhesion of the contracted iris to the front of the 
lens capsule. It is in short, a posterior synechia with closure of 
the pupil. The lens and its capsule are usually opaque so that 
there would be no gain in detachment of the iris. If, however, 
there is reason to conclude that any part of the lens is still trans- 
parent, the performance of iridectomy over this portion, would 
produce a new aperture for the entrance of light. 



CYCLITIS. 



This is described by Moller as occurring in the domestic ani- 
mals, but he fails to furnish instances of its diagnosis during 
life, and it is not likely to be often recognized in the living ani- 
mal. Beside the usual signs of iritis, there is extreme tender- 
ness to pressure around the anterior border of the sclera, increase 



Cysts and Tuberculosis of the Iris. 403 

of intra-ocular pressure, followed later by its diminution, and a 
cloudiness of the anterior portion of the vitreous humor. This 
last condition can only be detected by a full illumination of the 
vitreous, and its examination with the ophthalmoscope. It is 
quite liable to be complicated by suppuration and to go on to 
panophthalmitis. 

The treatment does not materially differ from that of iritis, yet 
atropia must be used with caution as it is liable to increase the 
suffering. The preparations of mercury have been especially 
recommended. 



CYSTS OF THE IRIS AND CORPORA NIGRA. 

Mayer speaks of these lesions in horses, but it is very difficult 
to diagnose them correctly, even with the aid of the ophthalmo- 
scope. The very manifest bulging at the part may be due to ex- 
cess of pigment, especially in the corpora nigra, and an explora- 
tory puncture would only be warranted when the protrusion be- 
came excessive and injurious. One such puncture by Eversbusch 
led to infection and loss of the eye. 



TUBERCULOSIS OF THE IRIS. 

This has occurred as the result of inoculation of the aqueous 
humor in the smaller animals, and as a spontaneous localization 
of the disease in cattle (Hess, Roder, Fischoder, etc. ). In Hess's 
case, the left eye was shrunken to half the size of the sound right 
eye, and small caseated tubercles were present in both iris and 
choroid. There are usually coincident tubercles in other organs, 
and these with the nodular appearance of the iris swellings, if 
visible in life, may assist in diagnosis. (See Symptomatic Iritis 
and Tuberculosis J) 



CHOROIDITIS. 

Caiuea : m in iritis : traumatic and infective. Exudative. Suppurative. 
Symptoms : as in iritis : less change in iris and of flocculi in the aqueous 
humor ; opacity of lens and vitreous. Lack lustre choroid under ophthal- 
moscope, uneven, detached. Suppurative form : early profuse weeping, 
bleeding, later suppuration, pus oozing from orifice; panophthalmitis. 
Treatment : as in . iritis ; atropia ; cocaine ; astringents ; purgatives ; 
diuretics. , 

Causes. These are largely the same as those of iritis and cy- 
clitis. Blows, tratimas, foreign bodies, sand, cinders, dust, lime, 
fierce light, reflection from snow, water, etc., chills, draughts, 
storms, irritant gases, and a number of specific diseases like in- 
fluenza, contagious pneumonia, canine distemper, rheumatism, 
omphalitis, pyaemia, etc., may be named. It is a common lesion 
of recurrent ophthalmia in horses, and is not unknown in tuber- 
culous cattle. It is usually more or less involved in iritis, as 
the iris is in choroiditis. The name given to the disease which 
involves both, will depend mainly on whether the inflammation 
predominates in the iris or choroid. Mayer divides it into exu- 
dative and suppurative, the latter being the common result of 
trauma, and likely to issue in panophthalmitis. 

Symptoms, These are largely those of iritis. The congestion 
and redness oi the sclerotic around the margin of the cornea, the 
fact that the enlarged vessels are firm in the sclera and not easily 
moved as in conjunctival congestion, and a certain partial blind- 
ness, without much change in the brilliancy of the iris, or opacity 
or flocculi of the aqueous humor, would suggest choroiditis. 
Later some opacity of the lens, or its capsule or of the vitreous 
humor would be equally significant. 

The only certain manifestations would be such as are found on 
ophthalmoscopic examination. Swelling and unevenness of the 
inner surface of the choroid, and a loss of luster, a change of its 
dark surface to light colored spots and patches, (dull-red, yellow- 
ish red, grayish green) and of the tapetum lucidum to a dirty 
grayish green in solipeds. Areas of minute blood clot may also 
be seen. But these are rarely recognized or indeed skillfully 
sought during life, and it is mainly to necropsies that we owe most 
of our diagnosis of choroiditis in the lower animals. 
404 



Detachment of the Choroid. 405 

In the suppurative form there is early profuse lachrymation 
more or less tinged with blood, and later oozing of pus from be- 
tween the lids. The redness and swelling of the conjunctiva 
and lids are very prominent features, and if the lids can be sepa- 
rated the corneal or scleral orfice may be seen oozing pus. If 
visible at all, the anterior chamber shows yellowish opaque con- 
tents, and the symptoms of panophthalmitis supervene. 

Treatment of the exudative form is essentially the same as 
for iritis. Atropia lotions with or without cocaine, also astrin- 
gents, which may be used warm, and generally purgatives, 
diuretics, local bleeding, cupping, and counter-irritants are in 
order. In obstinate cases ointment of the yellow iodide of mer- 
cury, and in cases of extra tension puncture of the cornea may 
be the means of relief. Colargol or pyoktanin is a safe anti- 
septic. Iridectomy may be advantageous under careful anti- 
septic precautions. In case of extensive or general suppuration 
{Mnophthalmitis) enucleation of the eye may be the only resort, 
and may contribute to save the other eyeball. (See Panophthal- 
mitis. ) 



DETACHMENT OF THE CHOROID. 

The choroid is detached from the sclera by exudates, blood 
effusions, or blows with blunt articles. The lesion is especially 
common in recurrent ophthalmia, choroiditis, and.cyclitis. The 
ophthalmoscope will show the detached portion as a rounded 
elevation on the otherwise smooth concave surface, with normal 
or diminished intraocular tension. A tumor of the choroid is 
usually associated with increase of tension. After inflammation 
has been subdued these cases may be left to rest and time, and 
will often recover through absorption of the exudate. Rupture 
of the choroid from violence is to be similarly dealt with. 



RECURRENT OPHTHALMIA OF SOUPEDS. PERIODIC 
OPHTHALMIA. MOONBLINDNESS. 

Definition. Causes: nvet impermeable soil, clay, river bottoms, deep 
valleys, inundations, enclosing forests, damp air, lack of sunshine, rank 
fodders, wet seasons, damp, cold, basement' stables, heating constipating 
fodder (com, buckwheat, wheat), dentition, training, age of domestication, 
sale, etc., spring, shedding coat, heredity, debility, ill health, worms, de- 
bilitating infectious diseases, over work, insufficient, indigestible food, 
local irritants. Microbes. Rheumatism. Parasitism. Symptoms : fever 
variable, lack of vigor, sudden attack, irritation, photophobia, lachryma- 
tion, closed lids, contracted pupils, retracted eye, redness, swelling of lids, 
conjunctiva, haw, sclera, slight corneal opacity, with vascularity, aqueous 
turbid, flocculent, iris of dull color, sluggish, pupil contracted, hypopion, 
posterior chamber yellowish green, intraocular tension, crisis seventh to 
tenth day, convalescence fifteenth day. Recurrence. Obscurity of vision. 
Bye between attack : blue zone around cornea, eye seems smaller, retracted, 
prominent haw, angle in upper lid, dull iris, tint lighter, contracted pupil, 
cataract, alert ears. I«esions : exudates back of cornea, narrowed anterior 
chamber, sizy aqueous, thickened iris, adhesions of lens capsule, or iris, 
torn iris, lens opaque, fibroid, calcareous, atrophied, black cataract, vit- 
reous opaque, yellow, black, shrunken, choroid uneven, discolored, de- 
tached, retina with exudate, detacled, posterior chamber contracted. 
Prevention : drainage, mature horses for damp lands, liming soil, get fod- 
der from dry locality, don't breed in cloudy regions, good diet and regimen, 
avoid corn, wheat and buckwheat, Glauber salts, pure dry stable, exclude 
debilitating diseases and parasites, keep in hard muscular condition, change 
to dry locality, don*t breed from blind stock, legislation. Treatment : re- 
move causes, cure rheumatism or other morbid factor, darkness, antiphlo- 
gistics, laxative, diuretic, antimicrobian-potassium iodide, local bleeding, 
cupping, blister, seton, locally atropine, cocaine, pyoktanin, potassium 
iodide, sublimate, lead, puncture, tonics, treat corneal opacities. Jurispru- 
dence : return a newly bought horse in 30 days, (France) or more : extend 
the time if suspected. 

Definition, This is an inflammatory affection of the interior of 
the eye, intimately related to certain constitutions, soils, climates, 
and systems of management, showing a strong tendency to recur 
again and again, and usually ending in blindness from cataract 
or other destructive lesion. 

Causes, A wet, impermeable, swampy or undrained soil 
is a potent cause of this disease. Heavy clays, which absorb and 
retain moisture, river bottoms and deltas whicTi are frequently 
406 



Recurrent Ophthalmia in Solipeds, Moonhlindness, 407 

overflowed and constantly wet, hollow basins where no effective 
drainage has been secured, and the coasts of seas and lakes which 
scarcely rise above^ the level of the water and are submerged at 
intervals, are the especial homes of the affection. In time past the 
disease was very prevalent in the low districts of France (Reynal), 
Belgium, Alsace- Loraine (Zundel, Miltenberger, ) Germany, Hol- 
land (MoUer), the English fen country and, above all, the damp 
lands of Ireland. Lafosse mentions a whole family of horses in 
South Western France which were characterized by blindness. 
Reynal records the terrible devastation which it caused in former 
times in the government studs at Limousin and Pompadour. It 
also prevails on the low banks of the Guadalquivir near Seville 
(Hurtrel d* Arboval), around Ostend, Cassel and Frankfort (Hof- 
geismar). At Saarburg in 406 horses on the drier limestone, 5 
per cent, were blind, while in 226 on the wet clay, 40 per cent, 
were blind (Schwartznecker). In Schlettstadt before drainage 
there were 75 per cent, blind : after drainage, 4 per cent. (Ziindel). 
Wet soils surrounded by forests or hills, which hinder free circu- 
lation of air, are especially injurious (Reynal). At Schlestadt, 
Alsace, at the beginning of this century, Miltenberger found 75 
per cent, of the horses of the environs affected, whereas after 
great drainage works and the removal of all stagnant water 
Ziindel found in 1870 not more than 2 per cent. In many locali- 
ties in England, Ireland, France, Belgium and Germany the dis- 
ease has greatly diminished in connection with land drainage and 
improved methods of culture. Harmon tells how in different 
parts of Brittany, drainage supplemented by the free use of marl 
and lime on the soil has caused a striking decrease in the prev- 
alence of the malady. In the department of Ain a ratio of 333 
per 1000 was thus reduced to 100 per 1000 (Reynal.) On the 
contrary, in the absence of such drying of the soil the previous 
high ratio of attacks was maintained. This has been notorious 
in the damp lands of Northern France and Belgium (Picardy, 
Artois, Flanders, where it often reaches 40 to 70 per cent. Reynal) : 
Alsace-Loraine, Holland, Hanover, Mecklenberg, North and 
East Prussia, Lithuania, the low parts of Austria and Hungary 
and the Danubian Principalities — Moldavia and Walachia. 

Reynal further shows that dealers are in the habit of taking 
young horses, which have so far escaped, or which have suffered 
but one moderate attack, away from the low damp soils of the low 



4o8 Veterinary Medicine, 

Pyrenees or of the Jura Valley in France to the dry elevated lands 
of Dauphiny, Provence and Lanquedoc in France, or to the 
mountainous regions of Catalonia in Spain in the well justified 
confidence that few of them will suffer a second attack. 

It is rare in native horses in Denmark (Bang), Norway and 
Sweden (Malm), but less so in imported German horses. 

As a direct test the French Government sent ten yearling foals 
from the affected depot at Limousin to the healthy depot at 
Tarbes, retaining an equal number at home as test animals ; it 
also sent ten yearlings from Tarbes .to Limousin, retaining an 
equal number at Tarbes as test cases. Then the twenty yearlings 
at Limousin were divided, five of the home bred and five drawn 
from Tarbes having been sent into a very low wet country at 
Lariviere, and the rest were sent to a high dry location at Mara- 
val. The result was that but one of the ten yearlings sent from 
Limousin to Tarbes contracted the disease, while on the damp 
land at Lariviere one Limousin-bred and four Tarbes-bred colts 
suffered ; and finally, on the dry soil at Maraval not a single colt, 
from either Limousin or Tarbes was attacked. 

The other conditions that .usually attach to a low, damp soil 
are important factors. Damp air and a cloudy, rainy climate 
are potent accessory causes. Hence the great prevalence of the 
disease formerly in Ireland, on the west coa^t and in the fen 
country in England, in Belgium, in the Low Pyrenees, in the 
valleys of the Loire, Jura, Meuse, Moselle, the Guadalquivir, . 
etc., (Reynal). Such an atmosphere relaxes the system, in- 
duces a heavy lymphatic temperament, with coarse bones and 
muscles, an excess of connective tissue, thick hide and hair, and 
thick, shaggy and often gummy legs. All this implies a low 
tone of health which will less effectually withstand inimical 
influences. 

The rank, aqueous fodders grown on such damp localities 
have a similar effect. These are more bulky and less nutritive 
and fail to maintain the highest tone and vigor. The animals 
must overload the stomach and intestines in order to obtain the 
requisite amount of nutriment, so that with a large, pendent 
belly they are still in poor condition. The case is even aggra- 
vated when they go on the succulent grasses of early spring, as 
they continue to gorge and may even make fat, but they lack in 
muscle and tone and in this condition even the rapid formation 



Recurrent Ophthalmia in Solipeds. Moonhlindness, 409 

of blood seems to favor the attack. MoUer records the great 
prevalence of the disease in Central Germany in 1884, in connec- 
tion with excessive rainfall, inundations, and spoiled fodder. 
Leblanc, Foggia and Hugues give further instances. Hugues 
attributes the disease to a cr5rptogam growing on the fodder. 

Dard records that a low, overflowed meadow in the Soane bot- 
tom near Chalons, caused blindness in nearly all horses put upon it. 
Bouin quotes a case of a sewage irrigated meadow in Vendue 
which almost infallibly produced recurrent ophthalmia in the 
horses fed on its produc